EARLY-PREG: A Preconception Cohort Study Based on Counterfactuals to Study Maternal-Embryonic Molecular Interactions (EARLY-PREG)

April 24, 2026 updated by: Elard Koch, PhD, MELISA Institute Genomics & Proteomics Research SpA

EARLY-PREG: A Preconception, Longitudinal, Bidirectional, and Counterfactual Cohort Study of Women Seeking Pregnancy, Designed to Investigate Maternal-Embryonic Molecular Interactions During the Peri-implantation Window

EARLY-PREG is an open-cohort clinical study with a preconception, longitudinal, bidirectional and counterfactual design. The aim of this cohort is to investigate the proteomic signatures of maternal-embryonic communication by interrogating a growing biorepository of maternal fluids and tissues collected during the first two weeks after fertilisation.

Participants in the EARLY-PREG cohort consist of healthy couples seeking pregnancy, as well as women who are not seeking to conceive. The three main outcomes in the cohort are defined according to menstrual cycles in which conception is achieved and those in which conception is not achieved. Their clinical definitions are as follows:

  • Pregnancy with a full-term live birth refers to the cycle in which the ovum is fertilised, leading to pregnancy, with beta-hCG levels above the clinical threshold for a positive pregnancy test.
  • Early pregnancy loss refers to a miscarriage up to 12 6/7 weeks.
  • Non-pregnancy refers to a menstrual cycle in which conception does not occur, confirmed by a clinically negative beta-hCG test. When referring to the same individual, this is, by definition, considered the counterfactual to the corresponding conception cycle.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Successful pregnancy depends on a coordinated exchange of signals between the early embryo and the mother. This complex process begins immediately after fertilisation, during the pre-implantation period. Although it plays a critical role in preparing the maternal environment for pregnancy, the mechanisms behind this communication remain incompletely understood.

The unique 'dialogue' between the embryo and the mother is a bidirectional exchange known as embryo-maternal crosstalk. Evidence indicates that this interaction, mediated by molecular signals present in uterine fluid, supports appropriate embryo implantation and modulates the maternal immune system to facilitate tolerance of the developing embryo.

To date, the majority of knowledge in this field has been derived from animal models and in vitro studies, which may not fully represent the physiology of spontaneous human conception. The EARLY-PREG preconception open cohort has been established to address this gap by characterising embryo-maternal crosstalk in vivo. This study follows healthy women who are trying to become pregnant, following them from before conception through the first two weeks of a natural conception, with continued follow-up into pregnancy and childbirth.

Daily collection of a range of biological samples - including saliva, urine, blood, cervicovaginal fluid and cervicovaginal brushings - is undertaken during key phases of the menstrual cycle. These samples are processed, preserved and stored in a dedicated biorepository for subsequent analysis using omics-based approaches.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
223

Contacts and Locations

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

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Chile
      • Chiguayante, Chile
        • Recruiting
        • Clínica Sanatorio Alemán

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

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Women visiting gynaecologists, and midwives in private practices, public hospitals, and Family Health Centres (CESFAMs) in the Biobio region of Chile.

Description

Inclusion criteria:

  • being between 18 and 40 years of age
  • not being pregnant
  • normal colposcopy
  • body mass index (BMI) between 18 and 29
  • regular menstrual cycles (21-35 days)
  • absence of chronic diseases (hypertension, diabetes mellitus, cancer, depression, personality disorder, thyroid pathology, polycystic ovary syndrome, or hyperprolactinemia).
  • If seeking pregnancy, they were included if their partners were males between 18 and 40 years old, without pathologies (diabetes mellitus, depression, personality disorder, or cancer), were not taking chronic medication, without erectile disorders, BMI between 18 and 29.9, moderate alcohol use, and with no recreational drug use.

Exclusion criteria:

  • pregnant women
  • history of alcoholism
  • infertility treatment
  • endometriosis
  • pelvic inflammatory disease
  • pelvic surgery
  • allergy to latex or silicone
  • If seeking pregnancy, they were excluded if their partners were working in contact with pesticides, or with history of erectile dysfunction, or history of mumps in adulthood, or with chronic diseases, or with psychological problems.

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

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
CONCEPTION CYCLE
Conception cycle refers to the menstrual cycle in which the ovum is fertilised, leading to pregnancy. Confirmation of a conception cycle requires beta-hCG levels above the clinical threshold for a positive pregnancy test, which is determined in peripheral venous blood on the 14th day post-ovulation.
Other: EMBRYO EXPOSURE
The counterfactual design of EARLY-PREG enables the comparison of the systemic and localised physiological effects associated with embryo appearance and implantation in an individual (the factual) against the physiological state of the same individual without experiencing pregnancy (the counterfactual).
NON-CONCEPTION CYCLE
Non-conception cycle refers to a menstrual cycle in which pregnancy does not occur. When referring to the same individual, it is, by definition, considered the counterfactual to the conception cycle described above. Confirmation of a non-conception cycle requires a clinically negative beta-hCG test, determined in peripheral venous blood on the 14th day post-ovulation. This cycle is characterised by the absence of a clinical pregnancy.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Number of menstrual cycles leading to full-term pregnancies
Time Frame: From enrollment for up to six menstrual cycles (each cycle ranges from 21-35 days) or until pregnancy resulting in live birth, whichever occurs first.
This outcome refers to the menstrual cycle in which the ovum is fertilised, leading to pregnancy with a full term live birth. The conception cycle requires beta-hCG levels above the clinical threshold for a positive pregnancy test, which is determined in peripheral venous blood on the 14th day post-ovulation.
From enrollment for up to six menstrual cycles (each cycle ranges from 21-35 days) or until pregnancy resulting in live birth, whichever occurs first.
Number of menstrual cycles not leading to pregnancy
Time Frame: From enrollment for up to six menstrual cycles (each cycle ranges from 21-35 days) or until pregnancy occurs, whichever occurs first.
This outcome refers to a menstrual cycle in which pregnancy does not occur. When referring to the same individual, it is, by definition, considered the counterfactual to the conception cycle described above. A non-conception cycle is confirmed by a clinically negative beta-hCG test, which is determined in peripheral venous blood on the 14th day post-ovulation. This cycle is characterised by the absence of a clinical pregnancy.
From enrollment for up to six menstrual cycles (each cycle ranges from 21-35 days) or until pregnancy occurs, whichever occurs first.
Number of menstrual cycles leading to early pregnancy loss
Time Frame: From the time beta-hCG levels rise above the clinical threshold for a positive pregnancy test until a miscarriage occurring up to 12 6/7 weeks.
This outcome refers to the menstrual cycle in which the ovum is fertilised, leading to a miscarriage until 12 6/7 weeks. The conception cycle requires beta-hCG levels above the clinical threshold for a positive pregnancy test, which is determined in peripheral venous blood on the 14th day post-ovulation.
From the time beta-hCG levels rise above the clinical threshold for a positive pregnancy test until a miscarriage occurring up to 12 6/7 weeks.

Collaborators and Investigators

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

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
MELISA Institute Genomics & Proteomics Research SpA

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Elard S Koch, MELISA Institute Genomics & Proteomics Research SpA

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.

Helpful Links

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)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 11, 2017

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 21, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 22, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 29, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 24, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 17-03-06
  • MEL109112011, MEL109112011R4 (Other Grant/Funding Number: Fundacion de investigacion san Ramon (FISAR))
  • MEL109112011R5, MEL131032017R1 (Other Grant/Funding Number: Fundacion de investigacion san Ramon (FISAR))
  • MEL205062018, REH042024-01 (Other Grant/Funding Number: Fundacion de investigacion san Ramon (FISAR))

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

All IPD information underlying the results of a publication will be shared with the sole exception of sensitive information that could reveal a person's identity.

IPD Sharing Time Frame

January 2027 - December 2028

IPD Sharing Access Criteria

The protocol data and results will be deposited in appropriate public repositories.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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