Strategies for Reducing Sperm DNA Fragmentation in ICSI Semen Samples: a Prospective Randomized Controlled Trial

August 6, 2022 updated by: Eman Hasanen, Ganin Fertility Center
Comparing second ejaculate and physiological ICSI (PICSI) as strategies for improvement of abnormal sperm DNA fragmentation in patients undergoing ICSI.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Sperm DNA fragmentation has shown a negative correlation with embryo quality, fertilization, implantation, clinical pregnancy, and live birth rates. And a positive correlation with the miscarriage rate. Abnormal sperm DNA fragmentation can be improved through the second ejaculate strategy, by limiting the time of sperm presence in the epididymis. PICSI is a robust sperm selection technique that can select individual mature intact sperm DNA. In our study, we will compare PICSI as a valid sperm selection technique to second ejaculate, as a natural cost-free strategy to manage abnormal SDF. In addition to a normal SDF arm as a control.

Study Type

Interventional

Enrollment (Actual)

300

Phase

  • Not Applicable

Contacts and Locations

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

Study Locations

    • القاهرة
      • Cairo, القاهرة, Egypt, 11728
        • Ganin Fertility Center

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

Ages Eligible for Study

14 years to 46 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Male partner with abnormal sperm DNA fragmentation index (>20%) by TUNEL assay
  • Male partner with at least 1 million progressive motile count
  • Male aged 18-50 years
  • Male with adjusted sexual abstinence days (1-2 days)
  • Female aged 18-37 years
  • Normo-responder females (at least 5 mature oocytes)

Exclusion Criteria:

  • Leukocytospermia
  • Varicocele
  • Known genetic abnormality
  • Use of oocyte or sperm donors
  • Use of a gestational carrier
  • Presence of any endometrial factors that can affect embryo implantation
  • Any contradictions to undergoing in vitro fertilization or gonadotropin stimulation

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

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Normal SDF
Using routine semen processing method
Active Comparator: Physiological ICSI (PICSI)
Sperm selection using PICSI dishes for selecting sperm with lower DNA fragmentation index for ICSI
Semen processing by density gradient centrifugation followed by sperm selection by PICSI dishes of the first ejaculate
Active Comparator: Second ejaculate
Using the second ejaculate as a way of reducing SDF in the semen sample used for ICSI
Semen processing by density gradient centrifugation for the second ejaculate

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Fertilization rate
Time Frame: 16-19 hours
Defined as the proportion of fertilized oocytes over the injected oocytes.
16-19 hours
Cleavage rate
Time Frame: 3 days
Defined as the proportion of cleaved embryos on day 3 over the injected oocytes.
3 days
Blastulation rate
Time Frame: 5-6 days
Defined as the proportion of blastocysts formed on day 5 or 6 over the cleaved embryos on day 3.
5-6 days
Blastocyst quality rate
Time Frame: 5-6 days
Defined as the assessment of blastocyst quality according to Gardner's criteria into: good, fair, or bad in terms of percentage of the total formed blastocysts.
5-6 days

Collaborators and Investigators

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

Sponsor

Investigators

  • Principal Investigator: Eman Hasanen, Ganin Fertility Center
  • Study Director: Hosam Zaki, MSc, FRCOG, Ganin Fertility Center
  • Principal Investigator: Radwa Omar, Ganin Fertility Center
  • Principal Investigator: Hanaa Alkhader, Ganin Fertility Center
  • Principal Investigator: Manar Hozayen, MSc., Ganin Fertility Center

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)

August 1, 2020

Primary Completion (Actual)

December 1, 2021

Study Completion (Actual)

December 1, 2021

Study Registration Dates

First Submitted

July 29, 2020

First Submitted That Met QC Criteria

July 29, 2020

First Posted (Actual)

August 3, 2020

Study Record Updates

Last Update Posted (Actual)

August 9, 2022

Last Update Submitted That Met QC Criteria

August 6, 2022

Last Verified

August 1, 2022

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • GFC-004

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Yes

IPD Sharing Supporting Information Type

  • Study Protocol
  • Statistical Analysis Plan (SAP)

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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