Comparing IVF/ICSI Cycle Outcomes of Post Ovulation Ovarian Stimulation Protocol With Elonva Without GnRH Antagonist to Follicular Phase Day 2 Stimulation Fixed Day 5 Antagonist Protocol

NCT ID: NCT06879002

Last Updated: 2025-10-02

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

NOT_YET_RECRUITING

Total Enrollment

252 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-12-30

Study Completion Date

2026-12-30

Brief Summary

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There are several approaches to the timing of antagonist administration in IVF/ICSI cycles. The primary goal is indeed to prevent premature ovulation, which could jeopardize the success of the cycle There is an emerging concept that suggests that the progesterone produced by the corpus luteum (formed after ovulation) might be sufficient to prevent further ovulation, obviating the need for antagonist or exogenous progesterone administration. This hypothesis relies on the natural regulatory mechanisms of the menstrual cycle to maintain a progesterone-dominated environment post-ovulation. We hypothesized that this approach would minimize treatment costs /burden without having an impact on the outcome.

Detailed Description

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Conditions

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Stimulation in the Ovary IVF Outcome

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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Group A: - Follicular phase start of ovarian stimulation with Elonva

Patients considered for ovarian stimulation for IVF/ICSI will be informed and a CF will be given on the day of planning for IVF. In group one, the ovarian stimulation protocol would follow a fixed GnRH antagonist protocol with recombinant FSH, Corifolitropin alfa (Elova150 mcg) starting on day 2 of the menstrual cycle.

Group A: Day 2-3 of cycle: Estradiol, Progesterone, Luteinizing Hormone, Follicle stimulating hormone During stimulation: on day 8 of stimulation: Estradiol, Progesterone, Luteinizing Hormone, Follicle stimulating hormone on trigger day: Estradiol, Progesterone, Luteinizing Hormone, Follicle stimulating hormone

Final oocyte maturation will be administered when 3 follicles reach 17mm or more. Oocyte retrieval will be performed 36 hours after human chorionic gonadotropin (hCG5000 or 10000IU, choriomon, IBSA) plus GnRH-a (0.2 or 0.3 mg Gonapeptyl, Ferring) administration under transvaginal ultrasound guidance.

Ovarian stimulation with menstruation or after ovulation

Intervention Type OTHER

Ovarian stimulation with menstruation or after ovulation

Group B: One day after the Positive LH kit test at home: E2 P4 LH FSH,BHCG

. In group two, Elona 150mcg is being administered after ovulation confirmation with home LH kits starting to be used around usual ovulation days, and be confirmed in clinic with LH rise, E2 drop and blood P4 more than 1ng/dl one day after LH kit is positive. The probability of spontaneous pregnancy will be ruled out by betaHCG test. In case a spontaneous pregnancy has been confirmed,we will not start the treatment . Furthermore, in case of sustained progesterone rise,repeated hCG tests will be performed throughout the stimulation cycle to monitor whether there is an early pregnancy or not. If so,the treatment will be cancelled/stopped to prevent the potential risks of stimulation medications during an early pregnancy.From stimulation Day 8 onwards, hormonal stimulation will continue with daily dose. The maximum injection dose for continuing treatment after the first 7 days will be 200 IU. (10) Final oocyte maturation will be administered when 3 follicles reach 17mm or more.

Ovarian stimulation with menstruation or after ovulation

Intervention Type OTHER

Ovarian stimulation with menstruation or after ovulation

Interventions

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Ovarian stimulation with menstruation or after ovulation

Ovarian stimulation with menstruation or after ovulation

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 18 to 38 years old.
* Normal Menstrual cycle of 25-35 days.
* Body Weight 60to90 kg
* AMH\>1.3 - \<3 ng/m (Ferraretti and Gianaroli, 2014; Calzada et al., 2019) an antral follicle count (AFC) of \>5 on menstrual cycle days 2-3,

Exclusion Criteria

* History of premature ovulation
* Azoospermia
* PCOS
* Endometriosis AFS ¾
* Endometrioma
* Known chromosomal abnormalities
Minimum Eligible Age

18 Years

Maximum Eligible Age

38 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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Maryam Farid Mojtahedi

Specialist IVF

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Barbara Lawrenz, PhD

Role: STUDY_DIRECTOR

ART Fertility Clinics LLC

Locations

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ART Fertility Clinics LLC

Abu Dhabi, , United Arab Emirates

Site Status

ART Fertility Clinics LLC - Dubai

Dubai, , United Arab Emirates

Site Status

Countries

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United Arab Emirates

Central Contacts

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Jonalyn Edades, EMBA

Role: CONTACT

+97126528000

Barbara Lawrenz, PhD

Role: CONTACT

+97126528000

Facility Contacts

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Jonalyn Edades, EMBA

Role: primary

+97126528000

Barbara Lawrenz, PhD

Role: backup

+97126528000

Jonalyn Edades, EMBA

Role: primary

+97126528000

References

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Ata B, Kalafat E. Progestin-primed ovarian stimulation: for whom, when and how? Reprod Biomed Online. 2024 Feb;48(2):103639. doi: 10.1016/j.rbmo.2023.103639. Epub 2023 Oct 22.

Reference Type BACKGROUND
PMID: 38159467 (View on PubMed)

Giles J, Cruz F, Garcia-Velasco JA. Progestin-primed ovarian stimulation. Curr Opin Obstet Gynecol. 2024 Jun 1;36(3):165-172. doi: 10.1097/GCO.0000000000000941. Epub 2024 Jan 30.

Reference Type BACKGROUND
PMID: 38295019 (View on PubMed)

Glujovsky D, Pesce R, Miguens M, Sueldo CE, Lattes K, Ciapponi A. How effective are the non-conventional ovarian stimulation protocols in ART? A systematic review and meta-analysis. J Assist Reprod Genet. 2020 Dec;37(12):2913-2928. doi: 10.1007/s10815-020-01966-5. Epub 2020 Nov 21.

Reference Type BACKGROUND
PMID: 33219862 (View on PubMed)

Kolibianakis EM, Venetis CA, Kalogeropoulou L, Papanikolaou E, Tarlatzis BC. Fixed versus flexible gonadotropin-releasing hormone antagonist administration in in vitro fertilization: a randomized controlled trial. Fertil Steril. 2011 Feb;95(2):558-62. doi: 10.1016/j.fertnstert.2010.05.052. Epub 2010 Jul 16.

Reference Type BACKGROUND
PMID: 20637457 (View on PubMed)

Other Identifiers

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2409-ABU-015-MF

Identifier Type: -

Identifier Source: org_study_id

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