Luteal Phase Defect Clinical Trial
Official title:
Oral Dydrogesterone Versus Vaginal Progesterone Gel in the Luteal Phase Support: Randomized Controlled Trial
The purpose of this study is to compare efficacy and tolerability of the dydrogesterone and
the vaginal progesterone, used for luteal phase support.
(Initial start date was January 2009 but not for patients' recruitment only for paper work,
documents, team organization, statistical pre-work actions and to gain the official approval
of Institutional Review Board. The recruitment started in October 2010 and continued until
October 2013.)
The use of gonadotropin-releasing hormone (GnRH) agonists in the ovarian stimulation, which
prevents a premature surge of luteal hormone (LH), ultimately leads to suppression of the
pituitary gland and high levels of estrogen observed during induced cycles result in
inhibiting effect on the implantation of human embryos.
The luteal support in in-vitro-fertilization (IVF) cycles can be prolonged using human
chorion gonadotropin(hCG) and/or progesterone.
Since it has been noted that the use of hCG was related with higher risks of the onset of
ovarian hyperstimulation syndrome (OHSS), progesterone is nowadays a product of choice in
luteal support.
Currently vaginal progesterone is widely used, since the classic oral progesterone results
in low bioavailability and lower pregnancy rate and the intramuscular progesterone (IM-P)
daily injections are painful and may cause abscesses, inflammatory reactions and local
soreness.
However, standard protocol for luteal phase support has not been established (i.e. optimal
dosage, route or duration).
Dydrogesterone is a retroprogesterone with good oral bioavailability. Oral administration is
clear advantage, due to expected higher patient compliance and better tolerability than
currently used vaginal or IM-P.
We hypothesize that dydrogesterone has the same efficacy as vaginal progesterone but better
tolerability due to less side effects.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment
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