Use of a Home-based PDG Urine Test to Confirm Ovulation

March 19, 2018 updated by: Bruyere Research Institute

Use of a Home-based Urinary Pregnanediol 3-glucuronide (PDG) Test to Confirm Ovulation

Infertility affects many people in Ontario and carries a significant amount of emotional, physical and financial burden to those who experience it. Knowing when a woman ovulates is important for improving a couple's chance to become pregnant naturally and for learning about fertility problems, such as infertility, irregular menses, and hormonal disorders.

Currently, there are two reliable methods to confirm ovulation: a trans-vaginal ultrasound or a blood test for progesterone, which is a hormone that only rises sharply after ovulation. However, both are time consuming and expensive. Recently, an inexpensive, home-based urine test strip has been developed to confirm ovulation. The test strip works by measuring urine for a marker of Progesterone, called pregnanediol-3a-glucuronide (PDG).

The purpose of this feasibility study is to follow the use of this home-based PDG urinary test strip over the course of one menstrual cycle in 25 female participants. The results of the urine test strip will then be compared to a Progesterone blood test. Participants will be recruited from the general Ottawa, Ontario area The ultimate aim of this study is to provide information for the design of a larger study to determine the accuracy of the PDG urinary test strip. If shown to be as effective in confirming ovulation, this test would provide substantial cost saving to the Ontario health care system and a much more convenient way for women and clinicians to confirm ovulation and determine if women are fertile.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Infertility affects many people in Ontario and carries a significant amount of emotional, physical and financial burden to those who experience it. More specifically, it impacts the couple's quality of life and can have detrimental effects related to marital conflicts, couple burnout and psychological disorders including a lack of confidence and depression.

As part of the standard evaluation of infertility, ovulatory function assessment is a fundamental step. Confirmation that ovulation has actually occurred can only be determined by performing a serum Progesterone test or by using the gold standard, serial transvaginal ultrasound. However, both of these investigations require visits to a physician, specialized laboratory testing, and in the case of ultrasound are often prohibitive due to its high costs and logistical demands.

In the female body, levels of Progesterone are low in the first half of the menstrual cycle. After the ovary releases an egg (ovulation) the corpus luteum produces high levels of Progesterone. Pregnanediol-3a-glucuronide (PDG) is the major urine metabolite of Progesterone. An inexpensive, home-based PDG urine test strip to confirm ovulation has recently been developed. The PDG test measures the presence of PDG in urine, which has been shown to directly correlate with the presence Progesterone in serum (blood). According to GLOWM (The Global Library of Women's Medicine) PDG levels in urine typically rise 24-36 hours after ovulation.

Although there also exists a home-based electronic hormone monitor for measuring urinary PDG, it is not widely available and is very time-consuming for women. Newer methods to monitor PDG using a simple urinary test strip that are less time consuming would be a welcome addition to the evaluation of infertility. Additionally, urinary hormonal tests have been proven to be easy and useful adjuncts to natural fertility markers.

The primary purpose of this feasibility study is to evaluate the use of the PDG urine test in a clinical setting to determine its accuracy to confirm ovulation when compared to the serum Progesterone test. This study will follow the use of the PDG urinary test strip over the course of one menstrual cycle in 25 female participants. In order to obtain participants, this study will use a non-probability sample using an initiation to volunteer technique for women in the general Ottawa area. The ultimate aim of this study is to provide information for the design of a larger study to determine the accuracy of the PDG urinary test strip.

Study Type

Interventional

Enrollment (Actual)

25

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Ontario
      • Ottawa, Ontario, Canada, K1N5C7
        • Bruyere Research Institute

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 42 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Females aged 18 to 42 years
  • Have had a menstrual cycle length of 25-35 days for the past 3 months
  • Are able to provide informed consent
  • Are willing to complete a trial diary

Exclusion Criteria:

  • Have current or recent (in the past 6 months) use of any hormonal contraception (e.g. the Pill, Norplant, Depo Provera injections)
  • Have current or recent (in the past 6 months) breastfeeding
  • Have use of emergency contraception (e.g. the morning after pill or Plan B) in the past two menstrual cycles
  • Cannot medically receive frequent blood tests, for example due to a blood clotting disorder
  • Are pregnant at the time of enrollment to study
  • Plan to donate blood during the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Device Feasibility
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Urine PDG test
Urine pregnanediol 3-glucuronide (PDG) test strip
Urine dipstick test that detects the presence of the urinary metabolite of progesterone, PDG.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sensitivity and specificity of the PDG urine test strip
Time Frame: 1 month
The sensitivity will be estimated as the proportion of true positives cycles, that is, cycles with appropriate recognition of the post-ovulatory phase. The specificity will be estimated as the proportion of true negatives cycles, that is, cycles with appropriate recognition of the pre-ovulatory phase.
1 month

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Frequency of protocol violation
Time Frame: 1 month
Percentage of participants who violated protocol to show acceptability of study design to participants.
1 month
Frequency of positive responses versus negative responses about the study procedures
Time Frame: 1 month
Ratio of positive responses to negative responses in the feedback questionnaire given to participants concerning the study protocol.
1 month
Frequency of positive responses versus negative responses on the study product
Time Frame: 1 month
Ratio of positive responses to negative responses in the feedback questionnaire given to participants concerning the study product.
1 month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Rene Leiva, MD, Bruyere Research Institute

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 23, 2017

Primary Completion (Actual)

March 14, 2018

Study Completion (Actual)

March 14, 2018

Study Registration Dates

First Submitted

July 24, 2017

First Submitted That Met QC Criteria

July 24, 2017

First Posted (Actual)

July 26, 2017

Study Record Updates

Last Update Posted (Actual)

March 20, 2018

Last Update Submitted That Met QC Criteria

March 19, 2018

Last Verified

July 1, 2017

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • M16-17-027

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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