- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03166189
Autologous Bone Marrow-derived Mesenchymal Stem Cells for Atrophic Endometrium in Patients With Repeated IVF Failures
Open Randomized Trial of Clinical Efficiency and Safety of Cell Product of Autologous Bone Marrow-derived Mesenchymal Stem Cells for Reparative Treatment of Destructively Changed Endometrium in Patients With Repeated IVF Failures
Study Overview
Status
Intervention / Treatment
Detailed Description
Sixty patients eligible for the study will be divided to two groups (experimental and control) according to randomization (envelope) procedure in 1:1 ratio.
For patients of the main group bone marrow stem cells will be extracted from the crest of the ilium using standard methodology. After extraction and cultivation final product of autologous bone marrow-derived mesenchymal stem cells will be transplanted to endometrial cavity on menstrual cycle day 5-6. Meanwhile patients will receive three cycles of hormonal replacement therapy (4 mg Progynova (Bayer Pharma, Germany) daily on menstrual cycle day 5-25 in combination with 20 mg Duphaston (Abbott Healthcare Products, B.V., Netherlands) daily from day 15 to day 25. On day 20 of hormonal replacement therapy (HRT) of the last (third) cycle Pipelle-biopsy of endometrium will be performed. Obtained material will be analyzed by immunohistochemistry with the assessment of estrogen and progesterone receptors, VEGFa, GM-CSF, CD133+, CD34 and CD56. Ultrasound characteristics of endometrial quality will be registered on day 9-10 and day 19-21 of every cycle. When morphological and echographic parameters of endometrium are found satisfactory for embryo transfer, the HRT for endometrial preparation for frozen/thawed embryo transfer cycle will be initiated. If acceptable endometrial characteristics are not achieved, patients could be offered to undergo repeated (not more than 3) transplantation of MSC procedures.
Control group will receive three standard cycles of HRT following hysteroscopy before frozen/thawed embryo transfer. If endometrial characteristics are found unsatisfactory, gestational surrogacy might be offered.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Saint Petersburg, Russian Federation, 199034
- D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Repeated IVF attempts with high and good quality embryo transfer in fresh and frozen IVF cycles;
- Age 20-44 years;
- Endometrial thickness less than 6 mm in 2 or more of HRT cycles for endometrial preparation for embryo transfer
- Hysteroscopic evidence of fibrosis processes of uterine cavity with the absence of positive dynamics of HRT in 3 months following operation;
- Signed informed consent.
Exclusion Criteria:
- Contraindication for pregnancy;
- Absence of cryopreserved embryos, stored at clinic's cryobank;
- BMI > 30 kg/m2;
- Impaired carbohydrate metabolism according to glucose tolerance test;
- Thrombosis in anamnesis;
- Oncological diseases in anamnesis;
- Diagnosed inherited thrombophilia;
- Uterine fibroids of more than 4 cm or more than 2 fibroids of 2.5 cm diameter;
- Nodal form of adenomiosis;
- Ovarian cysts more than 4 cm in diameter.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: bone marrow-derived MSC and HRT
endometrial injection of autologous cell product of MSC with hormonal replacement therapy before frozen/thawed ET
|
|
Active Comparator: hormonal replacement therapy
standard endometrial preparation for frozen/thawed ET
|
standard treatment of hypoplastic endometrium or Asherman's syndrome:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assessment of endometrial receptivity
Time Frame: 3-6 month after randomization
|
combination of endometrial thickness on ultrasound and immunohistochemistry of endometrium assessed at the biopsy day of the third cycle of HRT
|
3-6 month after randomization
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical pregnancy rate
Time Frame: 3-4 weeks after embryo transfer
|
presence of intrauterine gestational sac at transvaginal ultrasound at 5-6 weeks of gestation or 5-6 weeks after starting the intervention; measured per frozen/thawed embryo transfer
|
3-4 weeks after embryo transfer
|
Treatment-Emergent Adverse Events
Time Frame: 3-6 month after randomization
|
Incidence of adverse events: side reactions, abdominal discomfort and patient's tolerance (Safety and Tolerability)
|
3-6 month after randomization
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- MSC-001
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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