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TerminatedNCT06074055PREFERUpdated Feb 7, 2025

PRogrammed Versus Modified Natural Cycle After Euploid Failed Embryo Transfer

An interventional study of FET Protocol in Infertility, Female, sponsored by Reproductive Medicine Associates of New Jersey. Terminated at 2 sites in United States. Open to female participants aged 18 Years to 53 Years. Per ClinicalTrials.gov, last updated 2025-02-07.

Sponsored by Reproductive Medicine Associates of New Jersey · Not applicable, Interventional, and Treatment

Why this study was terminated
recruitment issues
Phase
Not applicable
Study type
Interventional
Enrollment
9
Allocation
Randomized
Ages
18 Years to 53 Years
Sex
Female
01

Study summary

The goal of this randomized clinical trial is to compare frozen embryo transfer protocols in patients undergoing a second frozen embryo transfer (FET) after a unsuccessful first programmed FET cycle as a possible treatment for people undergoing infertility treatment.

The purpose of this research study is to:

  • Determine if there is a difference between FET protocols in patients who require a second FET cycle.
  • Investigate if switching the FET protocol after a failed programmed cycle is beneficial for patients undergoing a second FET cycle.
  • Examine pregnancy outcomes including obstetrical and neonatal outcomes (if applicable)
  • Obtain uterine flexibility/stiffness measurements via transvaginal ultrasound prior to the embryo transfer procedure. This is called shear wave elastography.

Participants will be randomized in their second FET transfer attempt to either another programmed protocol or a modified natural protocol.

Read the detailed description

This research study is studying if there is a difference in frozen embryo transfer protocols used (modified natural versus programmed) after a failed first programmed FET cycle, defined as either a negative pregnancy test or a biochemical loss, as a possible treatment for people undergoing infertility treatment and in vitro fertilization (IVF). Participants will be randomized, in a 1:1 ratio, in their second FET transfer attempt to either another programmed protocol or a modified natural protocol. Once randomized, participants will undergo routine FET monitoring based on their randomization allocation, transfer procedure and pregnancy monitoring as applicable. Additional ultrasound images will be obtained prior to the transfer procedure to assess the stiffness or flexibility of the uterus, called shear wave elastography. A participant blood sample and infant buccal swab will be collected for future research studies.

02

Conditions studied

  • Infertility, Female
03

In context

Infertility

2,506 studies on the registry are indexed under Infertility; 407 are open to participants now.

This study's enrollment of 9 is below the median of 120 across 1,698 interventional studies indexed under Infertility.

Browse Infertility studies →

Lead sponsor

Reproductive Medicine Associates of New Jersey is the lead sponsor of 54 studies on the registry; 8 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 53 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Eligibility criteria

Major Inclusion Criteria: The following are major inclusion criteria:

  1. Patients planning to undergo frozen embryo transfer cycle with a single euploid blastocyst.
  2. Patients who have previously undergone their first unsuccessful frozen embryo transfer cycle, defined as either failure of implantation with negative pregnancy test or biochemical pregnancy, using a programmed cycle protocol.
  3. Preimplantation genetic testing for aneuploidy (PGT-A) of the embryo used in failed programmed embryo transfer cycle must have occurred after January 1, 2017.
  4. Patients ages 18 to 53 years old as per practice guidelines.
  5. Patients with BMI between 16-45 kg/m2.
  6. Patients with at least one embryo remaining in storage, from either the same or a separate cohort.
  7. Patients with proven ovulatory function, as defined by the presence of regular menstrual cycles or detection of luteinizing hormone surge on serum or urinary test kits.
  8. Patients with ≥ 7 mm endometrial thickness prior to progesterone start in prior transfer cycle.
  9. Normal uterine cavity as evidenced by recent (within 1 year) saline sonogram or hysteroscopy.

Major Exclusion Criteria: The following are exclusion criteria:

  1. More than 1 prior unsuccessful frozen embryo transfer cycle.
  2. The prior FET failure having had resulted in a clinical loss or ectopic pregnancy
  3. Previously cancelled frozen embryo transfer cycle for inadequate endometrial response.
  4. Patients who required a different route of estrogen administration in the prior programmed cycle (vaginal, transdermal, intramuscular).
  5. PGT-A analysis of the available embryo for transfer performed prior to January 1, 2017.
  6. Anovulatory or oligo-ovulatory patients unable to undergo modified natural endometrial preparation.
  7. Patients with an endometrial thickness \< 7 mm prior to progesterone start in prior cycle.
  8. History of hypertensive disorders of pregnancy, including gestational hypertension, preeclampsia, and eclampsia.
  9. Mullerian anomalies, excluding arcuate uterus and repaired septum.
  10. No euploid embryos available for transfer.
  11. Concurrent submucosal fibroids, unrepaired uterine defects or present indication for uterine surgery.
  12. Communicating hydrosalpinx without plans for surgical correction prior to study enrollment.
  13. Failure of patient to agree to enrollment in study with written consent.
  14. Concurrent pregnancy.
  15. Concomitant use of adjunctive therapies for endometrial proliferation or receptivity, including anticoagulation and antihistamines. These must be discontinued upon enrollment.
  16. Embryo planned to be used for transfer generated from surgically obtained sperm.
  17. Recurrent/persistent endometrial fluid in prior cycles visualized on the majority of transvaginal ultrasound monitoring.
  18. Third party reproduction patients (donor sperm sources can be included).
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
9 participants (actual)

Study arms

  • Other
    Programmed FET Protocol

    Patients in this arm of the study will proceed with another programmed FET protocol which involves taking exogenous estrogen by mouth to stimulate the uterine lining to grow and develop. Once the lining has reached ≥ 7 mm and an endometrial pattern of type 1 or type 2, intramuscular progesterone in oil (50mg/ml daily) will be started at 8am on the morning that progesterone is initiated and continued per routine.

    Other: FET Protocol

  • Other
    Modified Natural FET Protocol

    Following development of at least one dominant follicle and endometrial proliferation ≥ 7 mm during cycle monitoring, patient will undergo administration of human chorionic gonadotropin (hCG) trigger shot followed by initiation of vaginal progesterone administration in accordance with institutional protocols.

    Other: FET Protocol

Interventions

  • OtherFET Protocol

    Participants are randomized to either another programmed FET Protocol vs. a modified natural FET protocol

06

What researchers measure

Primary outcomes

  1. Sustained implantation rate

    presence of an intrauterine clinical pregnancy with fetal heart tones at 8 weeks gestational age

    Time frame: approximately 6 weeks after embryo transfer

Secondary outcomes

  1. Biochemical Pregnancy Rate

    Biochemical (positive serum beta human chorionic gonadotropin (bHCG) post transfer procedure)

    Time frame: approximately 9 days after transfer

  2. Biochemical pregnancy loss rate

    serum bHCG level ≥ 5 milli-International unit (mIU/mL) after FET without any ultrasound evidence of pregnancy until serum bHCG is \< 5 mIU/mL

    Time frame: typically 1 month post initial bHCG test

  3. Clinical Pregnancy Rate

    presence of an intrauterine gestational sac

    Time frame: approximately 10 days after initial pregnancy test

  4. Clinical Pregnancy Loss Rate

    a pregnancy after FET that had at minimum ultrasound evidence of a gestational sac, but did not progress to a live birth and was not terminated nor was an ectopic pregnancy.

    Time frame: approximately 2 months after FET procedure

  5. Live Birth Rate

    delivery of a live born infant greater than 24 weeks gestational age.

    Time frame: approximately 16-32 weeks post discharge at 8 weeks gestational age

  6. Rate of pregnancies of undetermined location and ectopic pregnancies

    Pregnancies that are not intrauterine

    Time frame: approximately 1-2 months post initial bHCG

  7. Rate of maternal obstetrical outcomes and complications

    mode of delivery, placental issues, preterm delivery

    Time frame: approximately 40 weeks gestation

  8. Rate of neonatal outcomes and complications

    gestational age at delivery, birth weight, any complications

    Time frame: approximately 40 weeks gestational age or after delivery of infant

  9. Elastography Data

    shear wave elastography measurements of the uterus

    Time frame: prior to the embryo transfer procedure

07

Study locations

2 sites
  • Reproductive Medicine Associates of New Jersey
    Basking Ridge, New Jersey 07920, United States
  • Reproductive Medicine Associates of New Jersey
    Marlton, New Jersey 08053, United States
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 7, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06074055
Lead sponsor
Reproductive Medicine Associates of New Jersey
Responsible party
Sponsor
First posted
Oct 10, 2023
Start date
Oct 25, 2023
Primary completion
May 10, 2024
Completion
Oct 21, 2024
Last update
Feb 7, 2025

Study contacts

Emre U Seli, MD
principal investigator · Reproductive Medicine Associates of New Jersey

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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