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Individualized Prolonged Luteal Support After Fresh Embryo Transfer in Women With Low Progesterone (ProLIS)

29 maggio 2026 aggiornato da: University Hospital, Montpellier

Interest of Individualized Prolongation of Subcutaneous Luteal Phase Support up to 8 Weeks for Patients Pregnant After a Fresh Embryo Transfer and With Low Serum Progesterone Level at Pregnancy Test - a Multicentric Randomized Double Blinded Controlled Trial

The goal of this clinical trial is to compare live birth rate in a control group versus an interventional group in subjects aged 18 to 37, pregnant after a fresh embryo transfer and with a serum progesterone level below 17 ng/mL on the day of pregnancy test while using vaginal progesterone as a luteal support. .

This is the first randomized controlled trial to assess the benefit of prolonged subcutaneous progesterone administration in patients with a positive pregnancy test (Bêta chorionique gonadotropic hormone: β-hCG >100 IU/L) after fresh transfer and low progesterone level (<17 ng/mL).

Half the participants will be offered a an extension of luteal phase support , by subcutaneous progesterone supplementation for 6 weeks, the other half will have placebo injections. A double-blind, placebo-controlled, randomized design was chosen to prevent selection bias and ensure the comparability of both study arms.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Introduction:

Progesterone is essential for implantation and early pregnancy maintenance. After ovarian stimulation for In vitro fertilization (IVF), luteal phase insufficiency may occur, requiring luteal phase support (LPS) with exogenous progesterone. Recent data suggest that patients with low serum progesterone levels (<17 ng/mL) at positive pregnancy test after fresh embryo transfer have lower live birth rates and higher miscarriage rates despite standard vaginal LPS.

Aim:

The primary objective of the study is to compare live birth rates between:

  • a control group receiving standard luteal phase support with vaginal progesterone until pregnancy test and placebo subcutaneous injections until 8 weeks of gestation, and
  • an intervention group receiving prolonged luteal phase support with subcutaneous progesterone until 8 weeks of gestation.

Secondary objectives include comparison of clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate, treatment-related adverse events, obstetrical and neonatal outcomes, gestational age at delivery, birth weight, and cost-effectiveness of the individualized prolonged luteal support strategy.

An ancillary biological sub-study conducted at Montpellier University Hospital will assess serum 17-hydroxyprogesterone and estradiol levels at inclusion.

Methods:

This study is a phase III, multicenter, randomized, double-blind, placebo-controlled trial.

Women aged 18-37 years with positive pregnancy test (Bêta chorionique gonadotropic hormone: β-hCG >100 IU/L) and serum progesterone <17 ng/mL after fresh embryo transfer will be randomized (1:1) to receive either:

  • subcutaneous progesterone (PROGIRON®) for 6 weeks, or
  • matching placebo for 6 weeks. To ensure adequate progesterone exposure during treatment initiation, vaginal progesterone (PROGESTAN®) will be continued for the first 4 days after randomization in both groups.

Participants will be followed until delivery. A total of 214 participants will be enrolled across multiple In vitro fertilization (IVF) centers.

Tipo di studio

Interventistico

Iscrizione (Stimato)

214

Fase

  • Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Patient aged 18 to 37 year-old;
  • Patients with a BMI below 34 kg/m2;
  • After a fresh embryo transfer following an ovarian hyperstimulation for an IVF with a luteal phase support based on micronized vaginal progesterone;
  • With a positive pregnancy test (β-hCG > 100 UI/L);
  • With a serum progesterone level below 17 ng/mL on the day of pregnancy test;
  • Patient able to self-administer subcutaneous progesterone injections, either alone or with the help of her partner.

Exclusion Criteria:

  • Patient undertaking an additional source of progesterone (oral or injected) or a treatment stimulating endogenous progesterone secretion (such as Gonadotropin-Releasing Hormone: GnRH agonist, or chorionique gonadotropic hormone: hCG injections);
  • Patients with intolerance or contraindication to subcutaneous progesterone administration;
  • Patients with a known 21-hydroxylase deficiency;
  • Patients with uterine pathology or untreated hydrosalpinx;
  • Patients with a history of recurrent miscarriages (3 or more);
  • Patient undergoing pre-implantation genetic testing;
  • Patient unavailable or unwilling to participate in future visits or is unable to comply with trial protocol;
  • Subjects unable to read or/and write French;
  • Failure to obtain the consent;
  • Subjects non-beneficiary of the French social security (Government medical aid (AME) excluded);
  • Subjects placed under legal protection, under guardianship or under curatorship;
  • Patient in an exclusion period determined by a previous study;
  • Subjects participating in another interventional research.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Doppio

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Comparatore placebo: Control group

Discontinuation of luteal phase support with a subcutaneous placebo daily until 8 weeks of gestation (for 6 weeks).

Vaginal progesterone will be continued for 4 days after placebo initiation. Apart from these 4 days of transition treatment, the patient will not receive any additional treatment for luteal phase support (discontinuation of progesterone soft capsule administration according to the center's standard practice).

One injection of PLACEBO (identical in appearance to the PROGIRON® pre-filled syringe) per day will be administered until 8 weeks of gestation (Day 1 to Day 42).
Altri nomi:
  • PLACEBO, injectable solution
Vaginal progesterone treatment with PROGESTAN® (200 mg 3 times daily) will be continued for 4 days after initiation of the investigational medicinal product (Day 1 to Day 4), pending achievement of stable progesterone serum concentrations with injectable progesterone.
Altri nomi:
  • PROGESTAN 200 mg, vaginal soft capsule
Sperimentale: Experimental group

Prolonged luteal phase support, switched to subcutaneous progesterone 25 mg daily until 8 weeks of gestation (for 6 weeks).

Vaginal progesterone will be continued for 4 days after subcutaneous progesterone initiation to ensure adequate serum levels while awaiting steady-state concentration of subcutaneous progesterone.

Apart from these 4 days of transition treatment, the patient will not receive any additional treatment for luteal phase support (discontinuation of progesterone soft capsule administration according to the center's standard practice).

Vaginal progesterone treatment with PROGESTAN® (200 mg 3 times daily) will be continued for 4 days after initiation of the investigational medicinal product (Day 1 to Day 4), pending achievement of stable progesterone serum concentrations with injectable progesterone.
Altri nomi:
  • PROGESTAN 200 mg, vaginal soft capsule
One injection of PROGIRON® (25 mg pre-filled syringe) per day will be administered until 8 weeks of gestation (Day 1 to Day 42).
Altri nomi:
  • PROGIRON 25 mg, injectable solution

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Live birth rate
Lasso di tempo: At postpartum follow-up (Visit 4: Month 9 ±1 month)
Defined as a birth of at least one live born baby, weighing 500 g or more or 20 weeks or more of gestation, with the birth of twins counted as one live birth.
At postpartum follow-up (Visit 4: Month 9 ±1 month)

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Clinical pregnancy rate
Lasso di tempo: At first trimester follow-up (Visit 3: Week 12-14 of gestation)

Defined as ultrasound visualization of a gestational sac, excluding ectopic pregnancy.

Multiple gestational sacs in one participant will be counted as one clinical pregnancy

At first trimester follow-up (Visit 3: Week 12-14 of gestation)
Ongoing pregnancy rate
Lasso di tempo: At first trimester follow-up (Visit 3: Week 12-14 of gestation)
Defined as a viable intrauterine pregnancy at ≥12 weeks of gestation.
At first trimester follow-up (Visit 3: Week 12-14 of gestation)
Miscarriage rate
Lasso di tempo: From inclusion (Visit 1: positive pregnancy test or the following day) to 20 weeks of gestation
Defined as spontaneous pregnancy loss before 20 weeks of gestation, including early pregnancy loss (<12 weeks) and late pregnancy loss (12-20 weeks).
From inclusion (Visit 1: positive pregnancy test or the following day) to 20 weeks of gestation
Incidence of treatment-related adverse events
Lasso di tempo: From inclusion (Visit 1: positive pregnancy test or the following day) to follow-up (Visit 2: Week 6-7 after test +)
Incidence of adverse events reported during the intervention period.
From inclusion (Visit 1: positive pregnancy test or the following day) to follow-up (Visit 2: Week 6-7 after test +)
Incidence of obstetrical and neonatal complications
Lasso di tempo: At postpartum follow-up (Visit 4: Month 9 ±1 month)
Including premature rupture of membranes, preterm labor or delivery, fetal growth restriction, hypertensive disorders, pre-eclampsia, gestational diabetes, macrosomia, placental abnormalities, birth defects, stillbirth, perinatal death, and neonatal hospitalization.
At postpartum follow-up (Visit 4: Month 9 ±1 month)
Birth weight
Lasso di tempo: At postpartum follow-up (Visit 4: Month 9 ±1 month)
Weight of the newborn at delivery.
At postpartum follow-up (Visit 4: Month 9 ±1 month)
Gestational age at delivery
Lasso di tempo: At postpartum follow-up (Visit 4: Month 9 ±1 month)
Gestational age in weeks at the time of delivery.
At postpartum follow-up (Visit 4: Month 9 ±1 month)
Incremental cost-effectiveness ratio (ICER)
Lasso di tempo: From inclusion (Visit 1: Positive pregnancy test or the following day) to postpartum follow-up (Visit 4: Month 9 ±1 month)
Cost-effectiveness analysis comparing prolonged subcutaneous progesterone versus placebo, with effectiveness defined by live birth rate.
From inclusion (Visit 1: Positive pregnancy test or the following day) to postpartum follow-up (Visit 4: Month 9 ±1 month)

Altre misure di risultato

Misura del risultato
Misura Descrizione
Lasso di tempo
Serum 17-hydroxyprogesterone level
Lasso di tempo: At inclusion (Visit 1: positive pregnancy test or the following day)
Sub-study objectives, only for participants from Montpellier University Hospital the serum levels of 17-hydroxy-progesterone (ng/mL) will be investigated on the day of inclusion.
At inclusion (Visit 1: positive pregnancy test or the following day)
Serum estradiol level
Lasso di tempo: At inclusion (Visit 1: positive pregnancy test or the following day)
Sub-study objectives, only for participants from Montpellier University Hospital the serum levels of estradiol (pg/mL) will be investigated on the day of inclusion.
At inclusion (Visit 1: positive pregnancy test or the following day)

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Investigatore principale: Noémie RANISAVLJEVIC, MD, PhD, University Hospital, Montpellier
  • Cattedra di studio: Tal ANAHORY, MD, University Hospital, Montpellier

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 marzo 2027

Completamento primario (Stimato)

1 settembre 2029

Completamento dello studio (Stimato)

1 settembre 2030

Date di iscrizione allo studio

Primo inviato

21 maggio 2026

Primo inviato che soddisfa i criteri di controllo qualità

21 maggio 2026

Primo Inserito (Effettivo)

29 maggio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

2 giugno 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

29 maggio 2026

Ultimo verificato

1 maggio 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • RECHMPL_25_0581
  • 2026-525452-28-00 (Ctis)

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .