Vaginal Compared to Intramuscular Progesterone for Frozen Embryo Transfer

NCT ID: NCT02254577

Last Updated: 2018-08-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

1139 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-10-31

Study Completion Date

2018-04-27

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

To determine whether the of vaginal progesterone replacement for frozen embryo transfer results in equivalent live birth rates to intramuscular injection progesterone replacement.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The purpose of this ongoing study is to look at whether Endometrin® (vaginal micronized progesterone tablets) supplemented by intramuscular injection of progesterone in oil (PIO) work as well as PIO alone for women undergoing transfer of frozen-thawed blastocyst(s). Another goal of the study is to determine whether patients prefer Endometrin or PIO. Endometrin® has been approved by the United States Food and Drug Administration, or FDA, "to support embryo implantation and early pregnancy by supplementation of corpus luteal function as part of an Assisted Reproductive Technology (ART) treatment program for infertile women." (FDA New Drug Approval Letter, Endometrin®, 2007). The use of Endometrin® (vaginal micronized progesterone tablets) in this study is investigational. An investigational use is one that is not approved by the U.S. Food and Drug Administration (FDA).

Approximately 1170 women between the ages of 18-48 who are having difficulty becoming pregnant and wish to undergo frozen embryo transfer will be asked to participate. The participants will be recruited from among patients of Shady Grove Fertility.

One-half of the participants who qualify and wish to take part in the ongoing study will be randomized (assigned by chance, like the flip of a coin) to receive Endometrin® and an intramuscular injection of PIO every third day. One-half will be randomized to receive an intramuscular injection of PIO every day. This study is a type of study called an "open label," assessor-blind study. This means that you and your doctor will know which treatment you are assigned and receive; however, the person analyzing the information obtained from the study will not know which patients received which study treatments.

Patients enrolling in the study will receive the medications for their frozen embryo transfer cycle free of charge.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Infertility

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Endometrin® plus Progesterone in Oil (PIO)

Subjects in all arms will undergo the standard monitoring appointments and therapies involved in a frozen embryo transfer cycle. Patients randomized to the Endometrin® plus PIO arm will take progesterone as 2 100mg tablets of Endometrin® inserted vaginally twice daily. In addition, on the first day of Endometrin® therapy, patients randomized to this arm will take a 50mg intramuscular injection (1mL) of PIO and will repeat this injection every third day. Patients in this arm will undergo Frozen Embryo Transfer on the fifth day of Endometrin® therapy.

Group Type EXPERIMENTAL

Endometrin® plus Progesterone in Oil (PIO)

Intervention Type DRUG

Progesterone in Oil (PIO) Alone

Subjects in all arms will undergo the standard monitoring appointments and therapies involved in a frozen embryo transfer cycle. Patients randomized to the PIO Only arm will take progesterone as a daily 50mg intramuscular injection (1mL) of PIO and will undergo Frozen Embryo Transfer on the sixth day of taking this medication.

Group Type ACTIVE_COMPARATOR

Progesterone in Oil (PIO) Only

Intervention Type DRUG

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Endometrin® plus Progesterone in Oil (PIO)

Intervention Type DRUG

Progesterone in Oil (PIO) Only

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Vaginal Micronized Progesterone Tablet Progesterone in Sesame Oil Injection Progesterone in Sesame Oil Injection

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Signed informed consent
2. Female age between 18 and 48 years
3. Having available blastocyst(s) frozen by vitrification method at our center (Shady Grove Fertility).
4. Standard eligibility criteria to undergo frozen blastocyst transfer at Shady Grove Fertility.

Exclusion Criteria

1. Requires fresh embryos or surrogate carrier
2. Embryos from frozen oocytes and embryos frozen more than once
3. Any embryo cryopreserved by slow freeze method and/or prior to blastocyst stage
4. Presence of any clinically relevant systemic disease contraindicated for ART
5. History of more than 3 failed cycles in previous ART attempts and/or more than 3 recurrent pregnancy losses after ET
6. Surgical or medical condition or requirement for medication, which may interfere with absorption, distribution, metabolism, or excretion of the drugs to be used
7. Subjects with a body mass index (BMI) of \<18 or \>38 kg/m2 at screening
8. Current or recent substance abuse, including alcohol and tobacco. (Note: Subjects who stopped tobacco usage at least 3 months prior to screening visit will be allowed)
9. Currently breast feeding, pregnant, or having (a) contraindication(s) to pregnancy
10. Refusal or inability to comply with the requirements of the protocol for any reason, including scheduled clinic visits and laboratory tests
11. Trophectoderm or blastomere biopsy of the blastocyst(s) to be transferred.
12. Documented intolerance or allergy to any of the medications used, including the study medication
13. Participation in any experimental drug study within 60 days prior to screening
14. If a subject undergoes more than two frozen blastocyst transfers meeting study criteria, she will only be eligible to enroll in the study for two of these.
Minimum Eligible Age

18 Years

Maximum Eligible Age

48 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Ferring Pharmaceuticals

INDUSTRY

Sponsor Role collaborator

Shady Grove Fertility Reproductive Science Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Shady Grove Fertility Center

Washington D.C., District of Columbia, United States

Site Status

Shady Grove Fertility Center

Washington D.C., District of Columbia, United States

Site Status

Shady Grove Fertility Center

Annapolis, Maryland, United States

Site Status

Shady Grove Fertility Center

Baltimore, Maryland, United States

Site Status

Shady Grove Fertility Center

Bel Air, Maryland, United States

Site Status

Shady Grove Fertility Center

Columbia, Maryland, United States

Site Status

Shady Grove Fertility Center

Frederick, Maryland, United States

Site Status

Shady Grove Fertility Center

Rockville, Maryland, United States

Site Status

Shady Grove Fertility Center

Towson, Maryland, United States

Site Status

Shady Grove Fertility

Camp Hill, Pennsylvania, United States

Site Status

Shady Grove Fertility Center

Chesterbrook, Pennsylvania, United States

Site Status

Shady Grove Fertility Center

Annandale, Virginia, United States

Site Status

Shady Grove Fertility Center

Leesburg, Virginia, United States

Site Status

Shady Grove Fertility Center

Woodbridge, Virginia, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Shapiro DB, Pappadakis JA, Ellsworth NM, Hait HI, Nagy ZP. Progesterone replacement with vaginal gel versus i.m. injection: cycle and pregnancy outcomes in IVF patients receiving vitrified blastocysts. Hum Reprod. 2014 Aug;29(8):1706-11. doi: 10.1093/humrep/deu121. Epub 2014 May 20.

Reference Type BACKGROUND
PMID: 24847018 (View on PubMed)

Feinberg EC, Beltsos AN, Nicolaou E, Marut EL, Uhler ML. Endometrin as luteal phase support in assisted reproduction. Fertil Steril. 2013 Jan;99(1):174-178.e1. doi: 10.1016/j.fertnstert.2012.09.019. Epub 2012 Nov 6.

Reference Type BACKGROUND
PMID: 23137759 (View on PubMed)

Paulson RJ, Collins MG, Yankov VI. Progesterone pharmacokinetics and pharmacodynamics with 3 dosages and 2 regimens of an effervescent micronized progesterone vaginal insert. J Clin Endocrinol Metab. 2014 Nov;99(11):4241-9. doi: 10.1210/jc.2013-3937. Epub 2014 Feb 25.

Reference Type BACKGROUND
PMID: 24606090 (View on PubMed)

Devine K, Richter KS, Jahandideh S, Widra EA, McKeeby JL. Intramuscular progesterone optimizes live birth from programmed frozen embryo transfer: a randomized clinical trial. Fertil Steril. 2021 Sep;116(3):633-643. doi: 10.1016/j.fertnstert.2021.04.013. Epub 2021 May 13.

Reference Type DERIVED
PMID: 33992421 (View on PubMed)

Devine K, Richter KS, Widra EA, McKeeby JL. Vitrified blastocyst transfer cycles with the use of only vaginal progesterone replacement with Endometrin have inferior ongoing pregnancy rates: results from the planned interim analysis of a three-arm randomized controlled noninferiority trial. Fertil Steril. 2018 Feb;109(2):266-275. doi: 10.1016/j.fertnstert.2017.11.004. Epub 2018 Jan 17.

Reference Type DERIVED
PMID: 29338855 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

SUSTAIN

Identifier Type: OTHER

Identifier Source: secondary_id

13-0028

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.