Vaginal Versus Combined Use of Progesterone in Fresh IVF/ICSI Cycles

NCT ID: NCT05089383

Last Updated: 2021-10-22

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

Total Enrollment

698 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-09-14

Study Completion Date

2023-12-31

Brief Summary

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Hypothesis: the combined use of progesterone administration for luteal phase support is superior to the single route of progesterone administration in terms of pregnancy outcome parameters in women undergoing fresh IVF/ICSI cycles.

Detailed Description

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In ART (IVF/ICSI), most of the studies have shown a deficiency of progesterone during the luteal phase, especially due to the use of GnRH analogs. The lack of progesterone leads to abnormal endometrial development and consequently to desynchronization between the latter and the blastocyst implantation. Therefore, it is a standard of care to use progesterone for luteal phase support after embryo transfer and during the first trimester, in case of pregnancy.

According to ESHRE guidelines, either of vaginal, oral, subcutaneous or intramuscular route is advisable.

But, until now, there is no robust evidence on the effect on pregnancy outcome of the combined route of progesterone administration compared to the standard of care (single route).

The aim of this study is to compare the effectiveness of the combined route of progesterone administration to the single route.

The study is a prospective cohort study. Participants will receive either standard treatment with single route (vaginal) progesterone administration according to the ESHRE guidelines, or combination of more than one routes of administration, that is vaginal plus oral or subcutaneous progesterone, starting afterthe fresh embryo transfer until 12 weeks of gestation or a negative pregnancy test.

Conditions

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Luteal Phase

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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combined progesterone group

patients will receive vaginal plus subcutaneous or per os progesterone

Utrogestan

Intervention Type DRUG

PROSPECTIVE STUDY

Vaginal progesterone group

patients will receive vaginal progesterone

Utrogestan

Intervention Type DRUG

PROSPECTIVE STUDY

Interventions

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Utrogestan

PROSPECTIVE STUDY

Intervention Type DRUG

Other Intervention Names

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PROLUTEX,VASCLOR

Eligibility Criteria

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Inclusion Criteria

* Patients with a documented history of infertility, aged 22-40, undergoing fresh embryo transfer after IVF/ICSI, under informed consent.
* Physiological menstrual cycles (24-35 days), normal endocrine function (FSH ≤ 15 IU / ml), transvaginal ultrasound without pathological findings, free personal medical history, indication for IVF/ICSI.

Exclusion Criteria

* Endocrine or metabolic disorders, e.g., PCO (S), pathology of the uterus and/or endometrium, basal FSH levels\> 15 IU / ml, major surgery in the ovaries (removal), and age \<22 years and \> 40 years old.
* Active pelvic inflammatory disease
* IVF/ICSI with donor eggs
* Previous participation in this trial
Minimum Eligible Age

22 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Iaso Maternity Hospital, Athens, Greece

OTHER

Sponsor Role collaborator

University of Athens

OTHER

Sponsor Role lead

Responsible Party

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Nikos Vlahos

Professor of Obstetrics, Gynecology and Assisted Reproduction

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nikolaos Vlachos

Role: STUDY_DIRECTOR

National and Kapodistrian University of Athens

Locations

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National and Kapodistrian University of Athens

Athens, Attica, Greece

Site Status RECRUITING

Countries

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Greece

Central Contacts

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Vasiliki Dourou

Role: CONTACT

+306977706799

Nikolaos Vlachos

Role: CONTACT

Facility Contacts

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Nikolaos Vlahos, Prof

Role: primary

Vassiliki Dourou, Midwife

Role: backup

6977706799 ext. 0030

References

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van der Linden M, Buckingham K, Farquhar C, Kremer JA, Metwally M. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev. 2015 Jul 7;2015(7):CD009154. doi: 10.1002/14651858.CD009154.pub3.

Reference Type BACKGROUND
PMID: 26148507 (View on PubMed)

Practice Committee of the American Society for Reproductive Medicine. Progesterone supplementation during the luteal phase and in early pregnancy in the treatment of infertility: an educational bulletin. Fertil Steril. 2008 Apr;89(4):789-92. doi: 10.1016/j.fertnstert.2008.02.012.

Reference Type BACKGROUND
PMID: 18406835 (View on PubMed)

Pabuccu E, Pabuccu R, Gurgan T, Tavmergen E. Luteal phase support in fresh and frozen embryo transfer cycles. J Gynecol Obstet Hum Reprod. 2020 Jun 22:101838. doi: 10.1016/j.jogoh.2020.101838. Online ahead of print.

Reference Type BACKGROUND
PMID: 32585391 (View on PubMed)

Tournaye H, Sukhikh GT, Kahler E, Griesinger G. A Phase III randomized controlled trial comparing the efficacy, safety and tolerability of oral dydrogesterone versus micronized vaginal progesterone for luteal support in in vitro fertilization. Hum Reprod. 2017 May 1;32(5):1019-1027. doi: 10.1093/humrep/dex023.

Reference Type BACKGROUND
PMID: 28333318 (View on PubMed)

Baker VL, Jones CA, Doody K, Foulk R, Yee B, Adamson GD, Cometti B, DeVane G, Hubert G, Trevisan S, Hoehler F, Jones C, Soules M. A randomized, controlled trial comparing the efficacy and safety of aqueous subcutaneous progesterone with vaginal progesterone for luteal phase support of in vitro fertilization. Hum Reprod. 2014 Oct 10;29(10):2212-20. doi: 10.1093/humrep/deu194. Epub 2014 Aug 6.

Reference Type BACKGROUND
PMID: 25100106 (View on PubMed)

Tomic V, Kasum M, Vucic K. The role of luteal support during IVF: a qualitative systematic review. Gynecol Endocrinol. 2019 Oct;35(10):829-834. doi: 10.1080/09513590.2019.1603288. Epub 2019 Apr 29.

Reference Type BACKGROUND
PMID: 31032676 (View on PubMed)

Griesinger G, Blockeel C, Sukhikh GT, Patki A, Dhorepatil B, Yang DZ, Chen ZJ, Kahler E, Pexman-Fieth C, Tournaye H. Oral dydrogesterone versus intravaginal micronized progesterone gel for luteal phase support in IVF: a randomized clinical trial. Hum Reprod. 2018 Dec 1;33(12):2212-2221. doi: 10.1093/humrep/dey306.

Reference Type BACKGROUND
PMID: 30304457 (View on PubMed)

Other Identifiers

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ARETAIEION UNIVERSITY HOSPITAL

Identifier Type: -

Identifier Source: org_study_id