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

NCT03230084 | Completed FDA Device

• 1 other identifier: M16-17-027
• Study Type: interventional
• Target: 25
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Infertility, Female

Keywords

Infertility; Ovulation; Pregnanediol 3-glucuronide; Progesterone; Urine dipstick test; Feasibility study; Fertile period; Menstrual cycle; Natural family planning; Fertility awareness methods

Outcome Measures

Primary Outcomes (1)

• Sensitivity and specificity of the PDG urine test strip

  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 Outcomes (3)

• Frequency of protocol violation

  1 month

• Frequency of positive responses versus negative responses about the study procedures

  1 month

• Frequency of positive responses versus negative responses on the study product

  1 month

Study Arms (1)

Urine PDG test

EXPERIMENTAL

Urine pregnanediol 3-glucuronide (PDG) test strip

Device: Urine PDG test

Interventions

Urine PDG test DEVICE

Urine dipstick test that detects the presence of the urinary metabolite of progesterone, PDG.

Urine PDG test

Eligibility Criteria

• Age: 18 Years - 42 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Bruyère Health Research Institute.: lead
• Rene Leiva, MD: collaborator
• Bruyere Foundation: collaborator

Study Sites (1)

Bruyere Research Institute

Ottawa, Ontario, K1N5C7, Canada

Location

Related Publications (24)

• Ecochard R, Leiva R, Bouchard T, Boehringer H, Direito A, Mariani A, Fehring R. Use of urinary pregnanediol 3-glucuronide to confirm ovulation. Steroids. 2013 Oct;78(10):1035-40. doi: 10.1016/j.steroids.2013.06.006. Epub 2013 Jul 4.

  PMID: 23831784 BACKGROUND

• Messerlian C, Fishman JR. Less is more: improving outcomes and cutting costs to Quebec's assisted reproduction program. CMAJ. 2014 Apr 1;186(6):405-6. doi: 10.1503/cmaj.131672. Epub 2014 Mar 3. No abstract available.

  PMID: 24591273 BACKGROUND

• Brown JB. Types of ovarian activity in women and their significance: the continuum (a reinterpretation of early findings). Hum Reprod Update. 2011 Mar-Apr;17(2):141-58. doi: 10.1093/humupd/dmq040. Epub 2010 Oct 5.

  PMID: 20923873 BACKGROUND

• Vigil P, Ceric F, Cortes ME, Klaus H. Usefulness of monitoring fertility from menarche. J Pediatr Adolesc Gynecol. 2006 Jun;19(3):173-9. doi: 10.1016/j.jpag.2006.02.003.

  PMID: 16731410 BACKGROUND

• Bushnik T, Cook JL, Yuzpe AA, Tough S, Collins J. Estimating the prevalence of infertility in Canada. Hum Reprod. 2012 Mar;27(3):738-46. doi: 10.1093/humrep/der465. Epub 2012 Jan 17.

  PMID: 22258658 BACKGROUND

• Ghavi F, Jamale S, Mosalanejad L, Mosallanezhad Z. A Study of Couple Burnout in Infertile Couples. Glob J Health Sci. 2015 Aug 6;8(4):158-65. doi: 10.5539/gjhs.v8n4p158.

  PMID: 26573033 BACKGROUND

• Evans-Hoeker E, Pritchard DA, Long DL, Herring AH, Stanford JB, Steiner AZ. Cervical mucus monitoring prevalence and associated fecundability in women trying to conceive. Fertil Steril. 2013 Oct;100(4):1033-1038.e1. doi: 10.1016/j.fertnstert.2013.06.002. Epub 2013 Jul 11.

  PMID: 23850303 BACKGROUND

• Robinson JE, Wakelin M, Ellis JE. Increased pregnancy rate with use of the Clearblue Easy Fertility Monitor. Fertil Steril. 2007 Feb;87(2):329-34. doi: 10.1016/j.fertnstert.2006.05.054. Epub 2006 Oct 30.

  PMID: 17074329 BACKGROUND

• Leiva R, Bouchard T, Boehringer H, Abulla S, Ecochard R. Random serum progesterone threshold to confirm ovulation. Steroids. 2015 Sep;101:125-9. doi: 10.1016/j.steroids.2015.06.013. Epub 2015 Jun 22.

  PMID: 26111590 BACKGROUND

• Practice Committee of American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2012 Aug;98(2):302-7. doi: 10.1016/j.fertnstert.2012.05.032. Epub 2012 Jun 13.

  PMID: 22698637 BACKGROUND

• Practice Committee of American Society for Reproductive Medicine in collaboration with Society for Reproductive Endocrinology and Infertility. Optimizing natural fertility: a committee opinion. Fertil Steril. 2013 Sep;100(3):631-7. doi: 10.1016/j.fertnstert.2013.07.011.

  PMID: 23993665 BACKGROUND

• Stanford JB. Revisiting the fertile window. Fertil Steril. 2015 May;103(5):1152-3. doi: 10.1016/j.fertnstert.2015.02.015. Epub 2015 Mar 13. No abstract available.

  PMID: 25772771 BACKGROUND

• Leiva R, Burhan U, Kyrillos E, Fehring R, McLaren R, Dalzell C, Tanguay E. Use of ovulation predictor kits as adjuncts when using fertility awareness methods (FAMs): a pilot study. J Am Board Fam Med. 2014 May-Jun;27(3):427-9. doi: 10.3122/jabfm.2014.03.130255.

  PMID: 24808123 BACKGROUND

• Ecochard R, Boehringer H, Rabilloud M, Marret H. Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation. BJOG. 2001 Aug;108(8):822-9. doi: 10.1111/j.1471-0528.2001.00194.x.

  PMID: 11510707 BACKGROUND

• Ecochard R, Duterque O, Leiva R, Bouchard T, Vigil P. Self-identification of the clinical fertile window and the ovulation period. Fertil Steril. 2015 May;103(5):1319-25.e3. doi: 10.1016/j.fertnstert.2015.01.031. Epub 2015 Feb 24.

  PMID: 25724738 BACKGROUND

• Blackwell LF, Vigil P, Alliende ME, Brown S, Festin M, Cooke DG. Monitoring of ovarian activity by measurement of urinary excretion rates using the Ovarian Monitor, Part IV: the relationship of the pregnanediol glucuronide threshold to basal body temperature and cervical mucus as markers for the beginning of the post-ovulatory infertile period. Hum Reprod. 2016 Feb;31(2):445-53. doi: 10.1093/humrep/dev303. Epub 2015 Dec 17.

  PMID: 26677961 BACKGROUND

• Sauer MV, Paulson RJ. Utility and predictive value of a rapid measurement of urinary pregnanediol glucuronide by enzyme immunoassay in an infertility practice. Fertil Steril. 1991 Nov;56(5):823-6. doi: 10.1016/s0015-0282(16)54649-4.

  PMID: 1936313 BACKGROUND

• Denari JH, Farinati Z, Casas PR, Oliva A. Determination of ovarian function using first morning urine steroid assays. Obstet Gynecol. 1981 Jul;58(1):5-9.

  PMID: 7195531 BACKGROUND

• Adlercreutz H, Brown J, Collins W, Goebelsman U, Kellie A, Campbell H, Spieler J, Braissand G. The measurement of urinary steroid glucuronides as indices of the fertile period in women. World Health Organization, Task Force on Methods for the Determination of the Fertile Period, special programme of research, development and research training in human reproduction. J Steroid Biochem. 1982 Dec;17(6):695-702. doi: 10.1016/0022-4731(82)90573-8.

  PMID: 7176659 BACKGROUND

• Sauer MV, Paulson RJ, Chenette P, Frederick J, Stanczyk FZ. Effect of hydration on random levels of urinary pregnanediol glucuronide. Gynecol Endocrinol. 1990 Sep;4(3):145-9. doi: 10.3109/09513599009009801.

  PMID: 2284979 BACKGROUND

• Stirnemann JJ, Samson A, Bernard JP, Thalabard JC. Day-specific probabilities of conception in fertile cycles resulting in spontaneous pregnancies. Hum Reprod. 2013 Apr;28(4):1110-6. doi: 10.1093/humrep/des449. Epub 2013 Jan 22.

  PMID: 23340057 BACKGROUND

• Wesselink AK, Wise LA, Hatch EE, Rothman KJ, Mikkelsen EM, Stanford JB, McKinnon CJ, Mahalingaiah S. Menstrual cycle characteristics and fecundability in a North American preconception cohort. Ann Epidemiol. 2016 Jul;26(7):482-487.e1. doi: 10.1016/j.annepidem.2016.05.006. Epub 2016 May 31.

  PMID: 27449569 BACKGROUND

• Bigelow JL, Dunson DB, Stanford JB, Ecochard R, Gnoth C, Colombo B. Mucus observations in the fertile window: a better predictor of conception than timing of intercourse. Hum Reprod. 2004 Apr;19(4):889-92. doi: 10.1093/humrep/deh173. Epub 2004 Feb 27.

  PMID: 14990542 BACKGROUND

• Leiva R, McNamara-Kilian M, Niezgoda H, Ecochard R, Bouchard T. Pilot observational prospective cohort study on the use of a novel home-based urinary pregnanediol 3-glucuronide (PDG) test to confirm ovulation when used as adjunct to fertility awareness methods (FAMs) stage 1. BMJ Open. 2019 May 27;9(5):e028496. doi: 10.1136/bmjopen-2018-028496.

  PMID: 31133596 DERIVED

Related Links

• : As couples search for satisfactory forms of contraception, some 'rediscover' a traditional method; others are introduced to birth control by an unconventional messenger.
• Fertility problems: assessment and treatment

MeSH Terms

Conditions

Infertility, Female; Infertility

Condition Hierarchy (Ancestors)

Genital Diseases, Female; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Genital Diseases

Study Officials

• Rene Leiva, MD

  Bruyère Health Research Institute.

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DEVICE FEASIBILITY
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 24, 2017
• First Posted: July 26, 2017
• Study Start: August 23, 2017
• Primary Completion: March 14, 2018
• Study Completion: March 14, 2018
• Last Updated: March 20, 2018

Record last verified: 2017-07

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)