Study the endometrial predecidualization by using subcutaneous progesterone 25 mg/day versus intramuscular progesterone 50 mg/day, to determine whether there are differences in the endometrial transformation and endometrial receptivity.
The aim of this study is to compare predecidualization and endometrial receptivity as gene expression by using subcutaneous progesterone 25 mg/day versus intramuscular progesterone 50 mg/day in healthy women of childbearing age. Both, the two drugs and the doses administered in this clinical trial, are routine clinical practice. A controlled ovarian stimulation will be previously performed and following routine clinical practice for 10-12 days at standard doses of subcutaneous FSH 150-225 IU/day, according to BMI and number of antral follicles. A GnRH antagonist shall be administered, being initiated according to donor's follicular growth from greater or equal14 mm diameter follicles. Final maturation shall be performed with a bolus of GnRH agonist when there exist at least 3 follicles greater or equal17 mm diameter, and therefore performing follicular puncture 36 hours after the bolus of agonist has been administered. If the donor meets the inclusion criteria, she will be informed of the study and, if she agrees, she will sign the informed consent. Randomization shall be performed in 2 arms; arm 1 will be administered subcutaneous progesterone 25 mg/day (Prolutex; Angelini, Spain), and arm 2, intramuscular progesterone 50 mg/day (Prontogest IBSA, Italy). In each arm 12 donors (ITT population) will be included. The randomization to a treatment group shall be performed the day the follicular puncture has been programmed. To that purpose, a randomized consecutive sampling will be used by means of assignment tables. The medication will be administered by a person not involved in the assessments and responsible for group assignment, data centralization and drug assignment. At day 5 (5 days after follicular puncture):endometrial thickness measurement by means of transvaginal ultrasound and perform endometrial biopsy and take two samples: 1 sample to Anatomical Pathology and 1 sample to Endometrial Receptivity Array (ERA).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
24
subcutaneous progesterone 25 mg/day
intramuscular progesterone 50 mg/day
IVI Barcelona
Barcelona, Spain
Predecidual Transformation
Histologic dating of the endometrium at day 5: early secretory phase, media secretory phase or late secretory phase
Time frame: 5 days
Decidualization of Stromal Cell
Rate of transformation of endometrial stromal fibroblasts into specialized secretory decidual cells (three categories: less than 25%, between 26% and 50%, and over 50%)
Time frame: 5 days
Endometrial Maturation Using Noyes' Criteria
Endometrial dating of luteal phase days according to the Noyes criteria
Time frame: 5 days
Endometrial Gene Expression
Gene expression profile of endometrial
Time frame: 5 days
Endometrial Gene Expression Difference
Genes with a significantly high gene expression difference (adj-p-value \< 0.05, Fold Change\>3)
Time frame: 5 days
Endometrial Thickness
Endometrial thickness measurement by means of transvaginal ultrasound.
Time frame: 5 days
Blood Estradiol Level
Blood estradiol level on the day of follicular puncture
Time frame: day 0
Blood Progesterone Level
Blood progesterone level on the day of follicular puncture
Time frame: day 0
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Blood LH Level
Blood Luteinizing hormone level on the day of follicular puncture
Time frame: day 0
Blood Estradiol Level
Blood estradiol level 5 days after progesterone treatment
Time frame: 5 days
Blood Progesterone Level
Blood progesterone level 5 days after progesterone treatment
Time frame: 5 days
Blood LH Level
Blood Luteinizing hormone level 5 days after progesterone treatment
Time frame: 5 days
Number of Participants With Side Effects During the Study
Number of Participants with side effects during the study"
Time frame: 5 days