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NCT Number: NCT06637189

Protocol with Progestin-primed Ovarian Stimulation (PPOS) from the Beginning of Stimulation Versus Protocol with GnRH Antagonists for Ovarian Stimulation in Patients Undergoing DUOSTIM with Embryo Accumulation for PGT-A.

The PPOS protocol (Progestin-primed Ovarian Stimulation) involves avoiding ovulation during ovarian stimulation with progesterone. It is a reliable and safe protocol that has been widely used in recent years for in vitro fertilization, as it reduces the number of injections needed during controlled ovarian stimulation and is more cost-effective for patients.

The aim of this study is to compare two methods of ovarian stimulation for in vitro fertilization: the PPOS protocol (Group A) and the conventional protocol with injected antagonists (Group B). The goal is to determine whether both methods are equally effective in obtaining euploid embryos in the context of double ovarian stimulation.

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Key information

Age range

18 year–43 year

Sex eligibility

Female

Study type

Interventional

Phase

Phase 4

About this study

Hypothesis:

Hypothesis: The number of euploid embryos obtained in a DUOSTIM cycle with PPOS is not inferior to that obtained with the use of antagonists.

General and Specific Objectives

Main Objective: To study if there is a difference in the number of euploid embryos obtained in two groups of patients undergoing embryo accumulation for PGT-A through double ovarian stimulation, comparing two methods of pituitary suppression: Progesterone use from the start of stimulation and the use of GnRH antagonists.

Secondary Objectives:

Evaluate if there are differences between both groups regarding the number of MII oocytes.

Evaluate if there are differences between both groups regarding the number of cumulus-oocyte complexes (COC).

Study the differences between both groups regarding the total consumption of gonadotropins.

Evaluate if there are differences between both groups regarding the number of stimulation days.

Evaluate if there are differences in fertilization rate after microinjection. Evaluate if there are differences between both groups regarding the cancellation rate.

Evaluate if there are differences between both groups regarding the number of total embryos.

Evaluate if there are differences between both groups regarding the number of embryos subjected to trophectoderm biopsy.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Regular menstrual cycles between 21 and 35 days, inclusive.
  • Indication of IVF with PGT-A.
  • Both ovaries present.
  • Ability to participate and complete the study.
  • Give and sign the consent to participate in the study.

Exclusion criteria

  • Endometriosis grade III/IV
  • Concurrent participation in another study

Treatment and study plan

Ganirelix

Drug

Ganirelix is a GnRH antagonist, which modulates the hypothalamic-pituitary-gonadal axis by competitively binding to GnRH receptors in the pituitary gland. Consequently, there is a reversible, intense, and rapid suppression of endogenous gonadotropin release. Ganirelix is indicated for the prevention of premature luteinizing hormone (LH) surges in women undergoing controlled ovarian hyperstimulation (COH) for assisted reproductive techniques (ART).

Medroxyprogesterone Acetate 10 MG

Drug

Medroxyprogesterone acetate is a synthetic progestin (structurally related to progesterone) with antiestrogenic, antiandrogenic, and antigonadotropic action. It inhibits pituitary gonadotropins (FSH and LH) with consequent inhibition of follicular maturation and ovulation . Medroxyprogesterone acetate is active orally and parenterally, 15 times more potent than progesterone. In addition to inhibiting ovulation, progestins also act on the endometrium preventing implantation and increasing the viscosity of cervical mucus, which hinders sperm progression in the uterus. It also transforms a proliferative endometrium into a secretory endometrium, provided that the woman has adequate endogenous estrogen levels.

Primary outcomes

  1. Number of Euploid Embryos

    Time frame: From date of randomization until the end of the treatment. Assessed up to 12 weeks.

    Total number of euploid embryos after the two egg retrievals

Secondary outcomes

  1. Number of Oocytes retrieved

    Time frame: From date of randomization until the end of the treatment. Assessed up to 12 weeks.

    Total number of oocytes retrieved after the two egg retrievals

  2. Number of Metaphase II oovcytes

    Time frame: From date of randomization until the end of the treatment. Assessed up to 12 weeks.

    Total number of metaphase II oocytes retrieved after the two egg retrievals

  3. Number of Fertilized Oovytes

    Time frame: From date of randomization until the end of the treatment. Assessed up to 12 weeks.

    Total number of fertilized oocytes after the two egg retrievals

  4. Number of Blastocysts

    Time frame: From date of randomization until the end of the treatment. Assessed up to 12 weeks.

    Total number of blastocyst stage embryos after the two egg retrievals

Study contacts

Contact information is provided by the study sponsor or research team.

Claudia Blancafort González-Casabón, MD

CONTACT

[email protected]

+34647437121

Joaquín Llácer, phD

CONTACT

[email protected]

Sponsors and collaborators

Lead sponsor

Ginefiv

Other

Collaborators

  • Theramex

Registry information

Acronym: PPDUO

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Oct 15, 2024
Registry last updated
Oct 15, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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