The Rate of Embryo Euploidy in Progestin-primed Ovarian Stimulation Cycles

NCT ID: NCT04654741

Last Updated: 2020-12-04

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

396 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-01

Study Completion Date

2022-12-31

Brief Summary

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The main objective of this non-inferiority randomized controlled trial is to assess the rate of blastocyst euploidy and the number of euploid blastocysts in women undergoing IVF/ICSI and treated with PPOS versus conventional ovarian stimulation based on the use of GnRH antagonist The hypothesis is that PPOS is associated with a rate of blastocyst euploidy similar to what found with the conventional ovarian stimulation. In other words, the number of euploid blastocysts that can be obtained with the PPOS strategy is expected to be the same obtained with conventional ovarian stimulation.

Moreover we expect to find non significant differences in all intermediate outcome of the IVF cycles, such as in the rate of premature LH surge, in the rate of patients with elevation of Progesterone on the triggering day, in FSH consumption and length of stimulation, in the rate of poor response and hyperresponse, in number of retrieved and mature oocytes, in fertilization and blastulation rate, in the number of available blastocysts and in the morphological quality of blastocysts

Detailed Description

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The study proposed is a non-inferiority randomized controlled trial Only patients undergoing PGT-A could be included. PGT-A will be proposed to couples for reasons of advanced maternal age, recurrent miscarriage, repeated implantation failure, or severe male infertility, as well as to all good-prognosis patients who desire information regarding the health status of their embryos.

396 patients will be included in this study (198 per arm). After randomization, patients will be treated according to the PPOS or conventional ovarian stimulation strategy. For all patients the ICSI and PGT-A will be applied and the intermediate and definitive outcomes of the ART cycles will be recorded.

Ovarian Stimulation Controlled ovarian stimulation will start on the second day of the menstrual cycle, with an initial dose of recombinant follicle stimulating hormone (rFSH) (chosen according to age, antral follicle count or serum AMH and body mass index,BMI) In addition to the gonadotrophin, participants will receive progestins (MPA) in the PPOS or GnRH antagonists in the conventional ovarian stimulation. Ovarian stimulation will culminate with the oocyte retrieval procedure.

Oocyte Insemination, Embryo Culture, and Biopsy. All biologic procedures will be performed as already described. Only oocytes with the first polar body extruded (metaphase II) will be treated with the use of ICSI immediately after the denudation procedure. Finally, injected oocytes will be moved to single drops of cleavage medium. Depending on the embryo's development, the blastocyst stage can be reached on day 5, 6, or 7. On the day of biopsy, 5-10 trophectoderm cells will be gently aspirated into the biopsy pipette followed by a laser-assisted removal from the rest of the blastocyst. Briefly, trophectoderm cell samples and negative controls will be processed according to the Illumina protocol.

Conditions

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IVF Infertility

Keywords

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PGT-A IVF ICSI Blastocyst GnRH antagonist Progestin

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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Progestin Primed ovarian stimulation Group

progestin 10 mg daily during ovarian stimulation

Group Type EXPERIMENTAL

Medroxyprogesterone Acetate

Intervention Type DRUG

1 pill per day

GnRH antagonist

GnRH antagonist 0.25 mg daily during ovarian stimulation

Group Type ACTIVE_COMPARATOR

Ganirelix Acetate

Intervention Type DRUG

1 injection per day

Interventions

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Medroxyprogesterone Acetate

1 pill per day

Intervention Type DRUG

Ganirelix Acetate

1 injection per day

Intervention Type DRUG

Other Intervention Names

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Farlutal Orgalutran

Eligibility Criteria

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Inclusion Criteria

* advanced maternal age,
* recurrent miscarriage,
* repeated implantation failure,
* severe male infertility,
* patients who desire information regarding the health status of their embryos.

Exclusion Criteria

* Ovarian cyst,
* previous surgery,
* abnormal karyotype,
* genetic or systematic disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Casa di Cura Privata Villa Mafalda

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Villa Mafalda

Roma, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Ermanno Greco

Role: CONTACT

Phone: +39335304960

Email: [email protected]

Facility Contacts

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Ermanno Greco, MD

Role: primary

Other Identifiers

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4/2018

Identifier Type: -

Identifier Source: org_study_id