Comparison of Vaginal and Intramuscular Progesterone in Vitrified-warmed Blastocyst Transfer Cycles

NCT ID: NCT02772120

Last Updated: 2019-09-09

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

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE4

Study Classification

INTERVENTIONAL

Brief Summary

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The aim of this study is to test the hypothesis that the pregnancy rates of women (ages 18-50 years) undergoing transfer of vitrified-warmed blastocysts (frozen at less than 41 years of age) as part of their IVF treatment are not different with respect to the administration of progesterone (Crinone® 8% vaginal gel versus intramuscular progesterone).

Detailed Description

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The hypothesis of this study is that the type of progesterone administered (intramuscular progesterone or Crinone® 8% vaginal gel) does not affect implantation and clinical pregnancy rates in women receiving cryo-thawed blastocysts that were produced using their own eggs and frozen before age 41 years. Both intramuscular progesterone (25-100 mg compounded in oil) or vaginal progesterone (Crinone® 8% vaginal progesterone gel) are widely used for luteal phase support in patients receiving vitrified-warmed embryos. Crinone® 8% is FDA approved for progesterone supplementation or replacement as part of an Assisted Reproductive Technology (ART) treatment for infertile women with progesterone deficiency (FDA approval letter, 1997).

Conditions

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Infertility

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Vaginal progesterone gel (Crinone® 8%)

Crinone® 8% (90 mg of micronized progesterone in a bioadhesive vaginal gel contained in a single use, one piece applicator) is administered once 5 days prior to embryo transfer, then twice per day until the pregnancy test is negative or until the 10th week of pregnancy.

Group Type ACTIVE_COMPARATOR

Vaginal progesterone gel (Crinone® 8%)

Intervention Type DRUG

Crinone® 8% (90 mg of micronized progesterone in a bioadhesive vaginal gel contained in a single use, one piece applicator) is administered once 5 days prior to embryo transfer, then twice per day until the pregnancy test is negative or until the 10th week of pregnancy.

Intramuscular Progesterone

Progesterone-25 mg intramuscularly once 5 days prior to embryo transfer, then 50 mg once per day until the pregnancy test is negative or until the 10th week of pregnancy.

Group Type ACTIVE_COMPARATOR

Intramuscular Progesterone

Intervention Type DRUG

Progesterone-25 mg intramuscularly once 5 days prior to embryo transfer, then 50 mg once per day until the pregnancy test is negative or until the 10th week of pregnancy.

Interventions

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Vaginal progesterone gel (Crinone® 8%)

Crinone® 8% (90 mg of micronized progesterone in a bioadhesive vaginal gel contained in a single use, one piece applicator) is administered once 5 days prior to embryo transfer, then twice per day until the pregnancy test is negative or until the 10th week of pregnancy.

Intervention Type DRUG

Intramuscular Progesterone

Progesterone-25 mg intramuscularly once 5 days prior to embryo transfer, then 50 mg once per day until the pregnancy test is negative or until the 10th week of pregnancy.

Intervention Type DRUG

Other Intervention Names

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vaginal progesterone Crinone progesterone

Eligibility Criteria

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Inclusion Criteria

* Signed informed consent
* Patient age at time of embryo freezing: 18 to 40.9 years
* Patient age at embryo transfer: 18 to 50 years (i.e. women currently ages 18-50 years who are transferring embryos created using eggs retrieved from women aged 18-40.9 years)
* Blastocysts frozen by vitrification at Brigham and Women's Hospital
* Standard eligibility criteria for blastocyst transfer at Brigham and Women's Hospital

Exclusion Criteria

* Fresh or cleavage-stage embryo transfer planned
* Gestational carrier cycles
* Natural and modified natural cycles
* Embryos frozen more than once or derived from thawed oocytes
* Embryos frozen at centers other than Brigham and Women's Hospital
* Embryos frozen using techniques other than vitrification (i.e. slow frozen)
* Patients with recurrent pregnancy loss, defined as failure of 3 or more clinical pregnancies
* Uterine factor infertility: Asherman's, submucosal fibroids, polyp greater than 1 cm at time of embryo transfer, uninterrupted hydrosalpinx
* Patients with three prior failed embryo transfers (fresh or frozen)
* BMI\<18 or \>40 kg/m2 at screening
* Currently breast feeding or pregnant
* Embryo biopsy performed
* Current smoking, alcohol or illicit drug use
* Allergy to study drugs
* Refusal or inability to adhere to study protocol
* Participation in other experimental drug trials concurrently within the past 60 days
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Brigham and Women's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Elena Hesina Yanushpolsky, MD

Assistant Professor, Harvard Medical School

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Elena Yanushpolsky, MD

Role: PRINCIPAL_INVESTIGATOR

Assistant Professor, Harvard Medical School, Director of Reproductive Surgery at Brigham and Women's Hospital

Locations

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Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Countries

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United States

References

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Wang Y, He Y, Zhao X, Ji X, Hong Y, Wang Y, Zhu Q, Xu B, Sun Y. Crinone Gel for Luteal Phase Support in Frozen-Thawed Embryo Transfer Cycles: A Prospective Randomized Clinical Trial in the Chinese Population. PLoS One. 2015 Jul 29;10(7):e0133027. doi: 10.1371/journal.pone.0133027. eCollection 2015.

Reference Type BACKGROUND
PMID: 26222435 (View on PubMed)

Lightman A, Kol S, Itskovitz-Eldor J. A prospective randomized study comparing intramuscular with intravaginal natural progesterone in programmed thaw cycles. Hum Reprod. 1999 Oct;14(10):2596-9. doi: 10.1093/humrep/14.10.2596.

Reference Type BACKGROUND
PMID: 10527993 (View on PubMed)

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)

Berger BM, Phillips JA. Pregnancy outcomes in oocyte donation recipients: vaginal gel versus intramuscular injection progesterone replacement. J Assist Reprod Genet. 2012 Mar;29(3):237-42. doi: 10.1007/s10815-011-9691-9. Epub 2012 Feb 4.

Reference Type BACKGROUND
PMID: 22310935 (View on PubMed)

Related Links

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Other Identifiers

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BWH2016progRCT

Identifier Type: -

Identifier Source: org_study_id

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