Current partner codePEPTIDESDE
NCT06637189·Phase 4·INTERVENTIONAL

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.

Status

Not yet recruiting

Phase

Phase 4

Enrollment

144

Locations

0

Results

Not posted

Publications

6

Study summary

What the protocol is testing.

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.

Full detailed description

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.

Interventions

Treatment arms and agents.

DRUG

Ganirelix

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).

DRUG

Medroxyprogesterone Acetate 10 MG

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.

Timeline

From registration to results.

  1. First posted

    Oct 15, 2024

  2. Study start

    Oct 15, 2024

  3. Primary completion

    Jun 15, 2025

  4. Study completion

    Dec 31, 2025

  5. Results posted

    Not reported

  6. Registry updated

    Oct 15, 2024

Outcomes

What the study measures.

Primary outcomes

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

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

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

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

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

Eligibility

Who can take part.

Minimum age
18 Years
Maximum age
43 Years
Sex
FEMALE
Healthy volunteers
Yes

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

Study locations

0 registered sites.

No country data reported. Showing up to 24 locations stored in the fast local snapshot.

No study locations reported.

Publications

Results and literature.

PMID 31062995Martinez F, Rodriguez-Purata J, Beatriz Rodriguez D, Clua E, Rodriguez I, Coroleu B. Desogestrel versus antagonist injections for LH suppression in oocyte donation cycles: a crossover study. Gynecol Endocrinol. 2019 Oct;35(10):878-883. doi: 10.1080/09513590.2019.1604661. Epub 2019 May 7.PMID 34867773Dong M, Sun L, Huang L, Wang F, Zhang X, Liu F. Fixed Gonadotropin-Releasing Hormone Antagonist Protocol Versus Flexible Progestin-Primed Ovarian Stimulation Protocol in Patients With Asynchronous Follicular Development During Controlled Ovulation Stimulation: A Retrospective Study. Front Endocrinol (Lausanne). 2021 Nov 18;12:690575. doi: 10.3389/fendo.2021.690575. eCollection 2021.PMID 31209815Xiao ZN, Peng JL, Yang J, Xu WM. Flexible GnRH Antagonist Protocol versus Progestin-primed Ovarian Stimulation (PPOS) Protocol in Patients with Polycystic Ovary Syndrome: Comparison of Clinical Outcomes and Ovarian Response. Curr Med Sci. 2019 Jun;39(3):431-436. doi: 10.1007/s11596-019-2055-x. Epub 2019 Jun 17.PMID 33814126Giles J, Alama P, Gamiz P, Vidal C, Badia P, Pellicer A, Bosch E. Medroxyprogesterone acetate is a useful alternative to a gonadotropin-releasing hormone antagonist in oocyte donation: a randomized, controlled trial. Fertil Steril. 2021 Aug;116(2):404-412. doi: 10.1016/j.fertnstert.2021.02.036. Epub 2021 Apr 2.PMID 30927417Begueria R, Garcia D, Vassena R, Rodriguez A. Medroxyprogesterone acetate versus ganirelix in oocyte donation: a randomized controlled trial. Hum Reprod. 2019 May 1;34(5):872-880. doi: 10.1093/humrep/dez034.PMID 33268401Wang N, Zhu Q, Ma M, Liang Z, Tao Y, Wang Y, Kuang Y. Comparison of a progestin-primed ovarian stimulation protocol with a flexible GnRH antagonist protocol in patients with polycystic ovary syndrome who are participating in an IVF programme: study protocol for a randomised controlled trial. BMJ Open. 2020 Dec 2;10(12):e038153. doi: 10.1136/bmjopen-2020-038153.

Primary links

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