Comparison of Live Birth Rate in Natural Cycle Single Euploid FET Versus Without Luteal Phase Support

NCT ID: NCT05969795

Last Updated: 2025-01-09

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

RECRUITING

Clinical Phase

PHASE1

Total Enrollment

342 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-05

Study Completion Date

2026-09-30

Brief Summary

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To evaluate whether single euploid embryo transfer in NC without routinely administered LPS is non-inferior to NC with routinely administered LPS.

Detailed Description

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In case the study will show that the live birth rate in single euploid NC frozen embryo transfer cycles without LPS is not inferior to NC cycles with LPS, treatment can be simplified, and participants comfort can be increased.

Conditions

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Pregnancy Related Infertility, Female

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Study Group

Intermittent ultrasound scans to monitor follicular growth and serial measurements of serum LH, E2 and P4 levels throughout the cycle to determine ovulation. Embryo transfer (ET) will be scheduled on the fifth day after ovulation. Blood for P4 measurement will be drawn upon admission to the clinic for the ET procedure. P4 will be measured on day 5 or day 6 after the ET procedure and together with the hCG 10 days after ET procedure.

Group Type OTHER

Transvaginal ultrasound

Intervention Type DIAGNOSTIC_TEST

Intermittent transvaginal ultrasound throughout the cycle to monitor follicular growth

Serial serum LH, E2, P4

Intervention Type DIAGNOSTIC_TEST

Serial measurements of serum Luteinizing Hormone (LH), Estradiol (E2) and Progesterone (P4 )levels throughout the cycle to determine ovulation. LH-surge is identified when a rise of 180% above the previous level occurred and ovulation is confirmed with a decrease in E2 concentration, and a rise of progesterone level to ≥ 1.0 ng/ml (Irani et al., 2017).

Serum P4 day of ET - Study Group

Intervention Type DIAGNOSTIC_TEST

Serum P4 will be drawn when study group participants are admitted to the clinic for the ET procedure.

Embryo transfer

Intervention Type PROCEDURE

The procedure in which embryo is placed in the uterus.

Serum hCG 10 days after ET

Intervention Type DIAGNOSTIC_TEST

Pregnancy will be confirmed / excluded by measurement of serum hCG 10 days after ET procedure and a level of \> 15 IU will be regarded as positive result. The definitions of biochemical, ectopic, clinical and ongoing pregnancy follow the ICMART criteria (Zegers-Hochschild, 2006)

Serum P4 10 days after ET

Intervention Type DIAGNOSTIC_TEST

Serum P4 will be drawn on day 5 or day 6 after the ET procedure and together with the hCG 10 days after ET procedure

Control Group

Intermittent ultrasound scans to monitor follicular growth and serial measurements of serum LH, E2 and P4 levels throughout the cycle to determine ovulation. Embryo transfer (ET) will be scheduled on the fifth day after ovulation. Administer on FET day 200 mg of P4 and increase to 300 mg/day from the day after the ET onwards until the pregnancy test. Blood for P4 measurement will be drawn before starting LPS in form of vaginal progesterone. P4 will be measured on day 5 or day 6 after the ET procedure and together with the hCG 10 days after ET procedure. In case of an implantation, vaginal P4 will be continued until 7 weeks of pregnancy.

Group Type OTHER

Transvaginal ultrasound

Intervention Type DIAGNOSTIC_TEST

Intermittent transvaginal ultrasound throughout the cycle to monitor follicular growth

Serial serum LH, E2, P4

Intervention Type DIAGNOSTIC_TEST

Serial measurements of serum Luteinizing Hormone (LH), Estradiol (E2) and Progesterone (P4 )levels throughout the cycle to determine ovulation. LH-surge is identified when a rise of 180% above the previous level occurred and ovulation is confirmed with a decrease in E2 concentration, and a rise of progesterone level to ≥ 1.0 ng/ml (Irani et al., 2017).

Progesterone 100 Mg Vaginal Insert

Intervention Type DRUG

On day of ET procedure, to administer 200 mg of vaginal progesterone and increase to 300 mg/day from the day after the ET onwards until the pregnancy test. In case of an implantation, vaginal P4 will be continued until 7 weeks of pregnancy

Serum P4 day of ET - Control Group

Intervention Type DIAGNOSTIC_TEST

Serum P4 will be drawn before starting LPS in form of vaginal progesterone on the day of ET procedure

Embryo transfer

Intervention Type PROCEDURE

The procedure in which embryo is placed in the uterus.

Serum hCG 10 days after ET

Intervention Type DIAGNOSTIC_TEST

Pregnancy will be confirmed / excluded by measurement of serum hCG 10 days after ET procedure and a level of \> 15 IU will be regarded as positive result. The definitions of biochemical, ectopic, clinical and ongoing pregnancy follow the ICMART criteria (Zegers-Hochschild, 2006)

Serum P4 10 days after ET

Intervention Type DIAGNOSTIC_TEST

Serum P4 will be drawn on day 5 or day 6 after the ET procedure and together with the hCG 10 days after ET procedure

Interventions

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Transvaginal ultrasound

Intermittent transvaginal ultrasound throughout the cycle to monitor follicular growth

Intervention Type DIAGNOSTIC_TEST

Serial serum LH, E2, P4

Serial measurements of serum Luteinizing Hormone (LH), Estradiol (E2) and Progesterone (P4 )levels throughout the cycle to determine ovulation. LH-surge is identified when a rise of 180% above the previous level occurred and ovulation is confirmed with a decrease in E2 concentration, and a rise of progesterone level to ≥ 1.0 ng/ml (Irani et al., 2017).

Intervention Type DIAGNOSTIC_TEST

Progesterone 100 Mg Vaginal Insert

On day of ET procedure, to administer 200 mg of vaginal progesterone and increase to 300 mg/day from the day after the ET onwards until the pregnancy test. In case of an implantation, vaginal P4 will be continued until 7 weeks of pregnancy

Intervention Type DRUG

Serum P4 day of ET - Control Group

Serum P4 will be drawn before starting LPS in form of vaginal progesterone on the day of ET procedure

Intervention Type DIAGNOSTIC_TEST

Serum P4 day of ET - Study Group

Serum P4 will be drawn when study group participants are admitted to the clinic for the ET procedure.

Intervention Type DIAGNOSTIC_TEST

Embryo transfer

The procedure in which embryo is placed in the uterus.

Intervention Type PROCEDURE

Serum hCG 10 days after ET

Pregnancy will be confirmed / excluded by measurement of serum hCG 10 days after ET procedure and a level of \> 15 IU will be regarded as positive result. The definitions of biochemical, ectopic, clinical and ongoing pregnancy follow the ICMART criteria (Zegers-Hochschild, 2006)

Intervention Type DIAGNOSTIC_TEST

Serum P4 10 days after ET

Serum P4 will be drawn on day 5 or day 6 after the ET procedure and together with the hCG 10 days after ET procedure

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Progesterone 100Mg Vag Tab ET

Eligibility Criteria

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Inclusion Criteria

* Age: 18 to 40 years
* Regular ovulatory cycles
* Availability of at least one euploid embryo after Trophectoderm biopsy for PGT-A on day 5 or day 6
* Detection of ovulation by P4 rise \> 1.0 ng/ml after LH surge
* P4 value of at least 5 ng/ml on day 4 after ovulation

Exclusion Criteria

* History of repeated pre-menstrual spotting
* Factors affecting the implantation through anatomical changes of the uterus / ovaries or the tubes (adenomyosis, Asherman syndrome, endometriosis, uterine fibroids / polyps, isthmocele with intracavitary fluid presence, hydrosalpinx….)
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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ART Fertility Clinics LLC

OTHER

Sponsor Role lead

Responsible Party

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Barbara Lawrenz

Scientific Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Barbara Lawrenz, PhD

Role: PRINCIPAL_INVESTIGATOR

ART Fertility Clinics LLC

Locations

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ART Fertility Clinics LLC

Abu Dhabi, , United Arab Emirates

Site Status RECRUITING

ART Fertility Clinics Al Ain

Al Ain City, , United Arab Emirates

Site Status RECRUITING

ART Fertility Clinics Dubai

Dubai, , United Arab Emirates

Site Status NOT_YET_RECRUITING

Countries

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United Arab Emirates

Central Contacts

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Barbara Lawrenz, PhD

Role: CONTACT

+971 800 337845489

Jonalyn Edades, RN

Role: CONTACT

+971 800 337845489

Facility Contacts

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Barbara Lawrenz, PhD

Role: primary

+971 800 337845489

Anastasia Salame

Role: primary

+971 800 337845489

Carol Coughlan, PhD

Role: primary

+971 800 337845489

References

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Bortoletto P, Prabhu M, Baker VL. Association between programmed frozen embryo transfer and hypertensive disorders of pregnancy. Fertil Steril. 2022 Nov;118(5):839-848. doi: 10.1016/j.fertnstert.2022.07.025. Epub 2022 Sep 25.

Reference Type BACKGROUND
PMID: 36171152 (View on PubMed)

Csapo AI, Pulkkinen M. Indispensability of the human corpus luteum in the maintenance of early pregnancy. Luteectomy evidence. Obstet Gynecol Surv. 1978 Feb;33(2):69-81. doi: 10.1097/00006254-197802000-00001. No abstract available.

Reference Type BACKGROUND
PMID: 341008 (View on PubMed)

Filicori M, Butler JP, Crowley WF Jr. Neuroendocrine regulation of the corpus luteum in the human. Evidence for pulsatile progesterone secretion. J Clin Invest. 1984 Jun;73(6):1638-47. doi: 10.1172/JCI111370.

Reference Type BACKGROUND
PMID: 6427277 (View on PubMed)

Ginstrom Ernstad E, Wennerholm UB, Khatibi A, Petzold M, Bergh C. Neonatal and maternal outcome after frozen embryo transfer: Increased risks in programmed cycles. Am J Obstet Gynecol. 2019 Aug;221(2):126.e1-126.e18. doi: 10.1016/j.ajog.2019.03.010. Epub 2019 Mar 22.

Reference Type BACKGROUND
PMID: 30910545 (View on PubMed)

Pape J, Levy J, von Wolff M. Early pregnancy complications after frozen-thawed embryo transfer in different cycle regimens: A retrospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2022 Dec;279:102-106. doi: 10.1016/j.ejogrb.2022.10.015. Epub 2022 Oct 21.

Reference Type BACKGROUND
PMID: 36308939 (View on PubMed)

Roelens C, Blockeel C. Impact of different endometrial preparation protocols before frozen embryo transfer on pregnancy outcomes: a review. Fertil Steril. 2022 Nov;118(5):820-827. doi: 10.1016/j.fertnstert.2022.09.003.

Reference Type BACKGROUND
PMID: 36273850 (View on PubMed)

Soules MR, Clifton DK, Steiner RA, Cohen NL, Bremner WJ. The corpus luteum: determinants of progesterone secretion in the normal menstrual cycle. Obstet Gynecol. 1988 May;71(5):659-66.

Reference Type BACKGROUND
PMID: 3357651 (View on PubMed)

Su S, Zeng M, Duan J. Luteal phase support for natural cycle frozen embryo transfer: a meta-analysis. Gynecol Endocrinol. 2022 Feb;38(2):116-123. doi: 10.1080/09513590.2021.1998438. Epub 2021 Nov 3.

Reference Type BACKGROUND
PMID: 34730071 (View on PubMed)

Practice Committee of the American Society for Reproductive Medicine. The clinical relevance of luteal phase deficiency: a committee opinion. Fertil Steril. 2012 Nov;98(5):1112-7. doi: 10.1016/j.fertnstert.2012.06.050. Epub 2012 Jul 20.

Reference Type BACKGROUND
PMID: 22819186 (View on PubMed)

von Versen-Hoynck F, Schaub AM, Chi YY, Chiu KH, Liu J, Lingis M, Stan Williams R, Rhoton-Vlasak A, Nichols WW, Fleischmann RR, Zhang W, Winn VD, Segal MS, Conrad KP, Baker VL. Increased Preeclampsia Risk and Reduced Aortic Compliance With In Vitro Fertilization Cycles in the Absence of a Corpus Luteum. Hypertension. 2019 Mar;73(3):640-649. doi: 10.1161/HYPERTENSIONAHA.118.12043.

Reference Type BACKGROUND
PMID: 30636552 (View on PubMed)

Related Links

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http://link.springer.com/10.1007/978-3-319-43011-9_63

Shapiro BS, Garner FC, Aguirre M. The Freeze-All Cycle: A New Paradigm Shift in ART. In Nagy ZP, Varghese AC, Agarwal A, editors. In Vitro Fertilization \[Internet\] 2019;, p. 765-778. Springer International Publishing

Other Identifiers

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2306-ABU-009-BL

Identifier Type: -

Identifier Source: org_study_id

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