Natural Cycle Versus Hormone Replacement Therapy Cycle for a Frozen-thawed Embryo Transfer in PGT Patients

NCT ID: NCT03976544

Last Updated: 2025-01-28

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

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

362 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-25

Study Completion Date

2025-01-01

Brief Summary

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The aim of the current study is to compare miscarriage rates (before 8 weeks) between a true natural cycle (awaiting spontaneous LH surge) and a hormone replacement therapy cycle prior to blastocyst transfer in preimplantation genetic testing (PGT) patients, with biopsy on day 5 of embryonic development. The advantage of performing the study in PGT patients is the exclusion of aneuploidy as a cause of miscarriage.

Detailed Description

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Conditions

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Miscarriage Frozen Embryo Transfer Natural Cycle Hormone Replacement Therapy Cycle Preimplantation Genetic Screening Euploid Embryos

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients will be randomized to either natural cycle frozen-thawed embryo transfer (group A), or hormonal replacement therapy cycle frozen-thawed embryo transfer (group B).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Natural cycle

Patients are asked to perform a blood sample, with evaluation of serum estradiol (E2), progesterone (P), luteinizing hormone (LH) and follicle stimulating hormone (FSH), on the first or second day of the menstrual cycle. If these serum hormonal values are considered basal for the beginning of the follicular phase, patients are asked to come back on day 10 to 12 of the cycle for blood sample and transvaginal ultrasound scan in order to assess follicular growth.

The timing of ovulation is determined based on a combination of ultrasonography features (the presence of a dominant follicle and adequate endometrium) and endocrine hormonal values in serum blood samples. Ovulation is generally defined as an, at least, 180% increase of LH compared to the mean level in the previous 24h.

Frozen-warmed blastocyst transfer will take place six days following the spontaneous LH surge.

Group Type NO_INTERVENTION

No interventions assigned to this group

Hormone replacement therapy cycle

Patients are asked to perform a blood sample, with evaluation of serum estradiol (E2), progesterone (P), luteinizing hormone (LH) and follicle stimulating hormone (FSH) on the first or second day of the menstrual cycle. If these values are considered basal for the beginning of the follicular phase, estrogen supplementation (Estradiol valerate, Progynova® 3x2mg/day) is started to induce proliferation of the endometrium. Blood sample and transvaginal ultrasound are thereafter performed ten to fourteen days later. If the endometrium is considered adequate (generally considered if triple line and above 6,5 mm thickness), embryo transfer is scheduled on the sixth day of progesterone (vaginal micronized progesterone, Utrogestan® 2x200mg twice a day) supplementation.

In case of escape spontaneous ovulation embryo transfer will be performed considering the presumable time of ovulation.

Group Type EXPERIMENTAL

Estradiol Valerate

Intervention Type DRUG

Estradiol valerate will be started in the beginning of the menstrual cycle in order to induce proliferation of the endometrium.

Micronized progesterone

Intervention Type DRUG

If the endometrium is considered adequately proliferated, micronized progesterone is administered and frozen-thawed blastocyst transfer will take place on the 6th day of supplementation.

Interventions

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Estradiol Valerate

Estradiol valerate will be started in the beginning of the menstrual cycle in order to induce proliferation of the endometrium.

Intervention Type DRUG

Micronized progesterone

If the endometrium is considered adequately proliferated, micronized progesterone is administered and frozen-thawed blastocyst transfer will take place on the 6th day of supplementation.

Intervention Type DRUG

Other Intervention Names

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Progynova Utrogestan

Eligibility Criteria

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Inclusion Criteria

* BMI under 35 kg/m2
* Regular menstrual cycle pattern (i.e. 24-35 days cycle)
* First, second and third ICSI-PGT cycle
* First frozen embryo transfer cycle following a fresh ICSI-PGT attempt
* PGT with trophectoderm biopsy on day 5 of embryonic development
* Signed informed consent

Exclusion Criteria

* Oligo-amenorrhea
* BMI above 35
* Contraindications for the use of hormonal replacement therapy
Minimum Eligible Age

18 Years

Maximum Eligible Age

42 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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CRG UZ Brussel

OTHER

Sponsor Role lead

Responsible Party

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Caroline Roelens

Clinical fellow

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Centre for Reproductive Medicine UZ Brussel

Brussels, , Belgium

Site Status

Countries

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Belgium

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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2018-003156-20

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

HRT_NC-FET

Identifier Type: -

Identifier Source: org_study_id

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