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Clinical Trials/NCT04499131
NCT04499131CompletedPhase 4

Exploratory Study on the Impact of Different Doses and Route of Administration of Exogenous Progesterone in Artificial Endometrial Preparation Cycles on Endometrial Structure and Function

Instituto Valenciano de Infertilidad, IVI VALENCIA1 site in 1 country109 target enrollmentStarted: December 9, 2021Last updated:
Conditions
Interventions
Drugs

Trial Snapshot

Phase
Phase 4
Status
Completed
Sponsor
Enrollment
109
Locations
1
Primary Endpoint
Endometrial gene expression profile

Study Overview

Brief Summary

After so many years conducting artificial endometrial preparation cycles for embryo transfer, there is no clear indication about which is the optimal dose of exogenous progesterone in this scenario to optimize the outcome. Taking into account that the luteal phase can be controlled by measuring serum P levels (not done until now), the next step is to find out which is the best dose and route of administration of exogenous progesterone for luteal phase in artificial cycles.

Therefore, the aim of this experimental study is to compare the endometrial function and structure, as well as the serum P levels according to the use of different types of exogenous progesterone available on the market depending on their doses and route of administration (vaginal, subcutaneous or intramuscular). The endometrial receptivity status will be compared in the different artificial cycles with the one observed in a natural cycle, without exogenous progesterone (only the endogenous one) as a control group.

Endometrial receptivity will be analysed by means of endometrial function and structure, but not by pregnancy outcome as in this study an embryo cannot be replaced in the uterus because an endometrial biopsy needs to be done to do this type of research.

Study Design

Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel
Primary Purpose
Treatment
Masking
Single (Investigator)

Masking Description

Patients will be evaluated by blinded gynecologist in order to prevent the application of personal criteria and protect the consistence of the study.

Eligibility Criteria

Ages
18 Years to 35 Years (Adult)
Sex
Female
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  • All women with no history of infertility who agree to participate in the study:
  • Age: 18-35 years old, both inclusive
  • Regular menstrual cycles
  • In good health and not suffering from any mental or medical condition(s) that would preclude participation in the study.

Exclusion Criteria

  • Subjects who meet one or more of the following will not be considered eligible to participate in the pilot study:
  • Simultaneous participation in other clinical studies that, at the researcher's criteria, could interfere with the results of this study.
  • Taking oral contraceptives in the three months prior to signing informed consent.
  • Presence of uterine pathology (submucosal or intramural myomas >4 cm deforming cavity, endometrial polyps or müllerian anomalies) or adnexal pathology (communicating hydrosalpinx).
  • Background of thrombosis, breast cancer, systemic diseases.
  • Those unable to comprehend the investigational nature of the proposed study.

Arms & Interventions

I: Artificial endometrial preparation cycle

Experimental

Artificial endometrial preparation cycle with estrogens and vaginal natural micronized progesterone 400mg/12h

Intervention: Progesterone (Drug)

II: Artificial endometrial preparation cycle

Experimental

Artificial endometrial preparation cycle with estrogens and subcutaneous natural progesterone 25mg/24h

Intervention: Progesterone (Drug)

III: Artificial endometrial preparation cycle

Experimental

Artificial endometrial preparation cycle with estrogens and subcutaneous natural progesterone 25mg/12h

Intervention: Progesterone (Drug)

IV: Artificial endometrial preparation cycle

Experimental

Artificial endometrial preparation cycle with estrogens and a combination of subcutaneous natural progesterone 25mg/24h + vaginal natural micronized progesterone 400mg/24h

Intervention: Progesterone (Drug)

V: Artificial endometrial preparation cycle

Experimental

Artificial endometrial preparation cycle with estrogens and intramuscular natural progesterone 50mg/24h

Intervention: Progesterone (Drug)

Natural menstrual cycle

Active Comparator

Natural menstrual cycle (without any exogenous steroid hormone Treatment)

Intervention: Artificial Cycle (no intervention) (Other)

Outcomes

Primary Outcomes

Endometrial gene expression profile

Time Frame: 12 months

Determination of gene expression

Secondary Outcomes

  • Histological dating of endometrial biopsies(12 months)
  • Progesterone concentration in the endometrium(12 months)
  • Serum Progesterone concentrations(12 months)
  • Correlation between progesterone levels in blood and uterus.(12 months)
  • Correlation between serum and uterine levels with endometrial transcriptome and histological dating(12 months)

Investigators

Sponsor
Instituto Valenciano de Infertilidad, IVI VALENCIA
Sponsor Class
Other
Responsible Party
Sponsor

Study Sites (1)

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