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Comparison of Vaginal and Transdermal Oestrogen Before Frozen Thawed Embryo Transfer

Conditions
Infertility
Embryo Transfer
Interventions
Registration Number
NCT03518528
Lead Sponsor
University Hospital, Angers
Brief Summary

The purpose of this study is to compare pregnancy outcomes of frozen-thawed embryo transfer after endometrial preparation with vaginal estradiol or transdermal estradiol and to evaluate women's satisfaction

Detailed Description

Frozen-thawed transfer embryo are more and more frequent but to date, there is no consensus on the ideal management of the adequate endometrial preparation.

Artificial preparation of endometrium is commonly used in assisted reproduction center because it is more easy to schedule.

Estradiol could be administrate by oral, vaginal or transdermal, but no protocol seems to improve clinical pregnancy rates.

To investigator's knowledge, transdermal estradiol has never been compare to vaginal administration before frozen-thawed embryo transfer.

Because transdermal administration could improve satisfaction of patients and reduce duration of treatment (when compare to oral administration), the investigators conduct a prospective study to compare clinical pregnancy rate after transdermal or vaginal estradiol administration to prepare the endometrium before frozen-thawed embryo transfer.

The investigator also evaluate side effects and patients satisfaction in both protocol.

The patients choose if they prefer vaginal or transdermal protocol after receiving sufficient information during medical consultation.

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
100
Inclusion Criteria
  • age ≥ 18 and <43
  • frozen-thawed embryo transfer after exogenously administered estrogen in either way transdermal or vaginal
  • patients who accepted being included and signed the consent forms.
Exclusion Criteria
  • patient who refuse to participate
  • frozen-thawed embryotransfer after stimulated or natural cycle
  • oocyte or sperm donation
  • endometrial thickness after 21 days <6mm
  • non-french speaking patients
  • women under legal guardianship
  • women with no health or social security coverage

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
transdermalEstradiol 100 µgtransdermal estradiol (Vivelledot, Novartis) 100 µg on day 3, then 200 µg day 7 and every 4 days, until first pregnancy test. If pregnancy test is positive, treatment is to continue until 8 weeks.
vaginalEstradiol 2 MGVaginal estradiol (Provames, Sanofi) 4mg per day from day 3 to first pregnancy test. If pregnancy test is positive, treatment is to continue until 8 weeks
Primary Outcome Measures
NameTimeMethod
clinical pregnancy12 weeks

defined as fetal cardiac activity at 12 weeks of gestation

Secondary Outcome Measures
NameTimeMethod
treatment duration21 days

duration of treatment before transfer

chemical pregnancy6 weeks

Defined as serum HCG levels \>10 IU/L, 14 days after the embryo transfer, followed by a rapid decrease until being undetectable

plasmatic lh concentration on the day of transfer21 days

plasmatic lh concentration on the day of transfer

plasmatic progesterone concentration on the day of transfer21 days

plasmatic progesterone concentration on the day of transfer

annulation21 days

defined when transfer is cancel if endometrial thickness is too thick (\>6-7mm), when spontaneous ovulation is found with progesterone plasmatic increase and corpus luteum is seen by sonography or when unpredictable events occur (infections, ZIKA suspicion, endometriosis crisis, bad observance...). Annulation could be decided by biologist in case of embryo's lysis or bad quality seen after thawing.

satisfaction evaluated by anonymous survey the day of transfer1 month

evaluated by anonymous survey the day of transfer

spontaneous pregnancy loss12 weeks

Including early and late pregnancy losses

plasmatic estradiol concentration on the day of transfer21 days

plasmatic estradiol concentration on the day of transfer

endometrial thickness21 days

sonographic measurement of endometrial thickness on the day of transfer

Trial Locations

Locations (1)

CHU Angers

🇫🇷

Angers, France

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