Effect of Sirolimus on Oocyte Quality in Women Undergoing IVF
Pilot Study of Sirolimus for Cycle Priming to Improve Oocyte Quality in Women Undergoing IVF
Poor oocyte (egg before maturation) quality remains a major barrier to IVF success, particularly in women with prior cycles demonstrating low oocyte maturity, poor fertilization rates, or suboptimal embryo development. Preclinical and early clinical evidence suggests that the mTOR pathway plays a critical role in oocyte and follicular development, and pharmacologic inhibition with sirolimus (also known as rapamycin), may improve oocyte competence by adjusting granulosa cell function and follicular aging processes.
We propose a multicenter pilot study enrolling participants at the Center for Human Reproduction (CHR) in New York and at the Division of Reproductive Endocrinology and Infertility at the University of Miami Miller School of Medicine. Participants will be aged 20-45 years with a documented history of poor oocyte quality in at least one prior IVF cycle, defined by low oocyte maturity (<50%), low IVM rates (<50%), poor fertilization (<70%), or suboptimal embryo quality (<50% cleavage-stage embryos or no embryos graded B4 or higher), despite normal ovarian response for age and reserve. After enrollment, participants will undergo ovarian priming with Sirolimus 1 mg orally daily in late luteal phase (from cycle-day 19-21 until menstrual period, hence for a total of 7-10 days), immediately preceding ovarian stimulation for embryo banking and later embryo transfer (after at least 12 weeks).
The primary objective is to evaluate the feasibility, safety, and preliminary efficacy of short-term sirolimus treatment for cycle priming prior to IVF, with the goal of improving oocyte quality and developmental competence. The main outcome will be embryo quality compared with historical cycles, although other secondary outcomes derived from egg quality will be assessed.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: David H. Barad, MD, MS
- Telefonnummer: 212-994-4400
- E-mail: dbarad@thechr.com
Undersøgelse Kontakt Backup
- Navn: Sonia Gayete Lafuente, MD, Ph.D
- E-mail: sgayete@thechr.com
Studiesteder
-
-
New York
-
New York, New York, Forenede Stater, 10021
- Rekruttering
- The Center for Human Reproduction
-
Kontakt:
- Sonia Gayete Lafuente, MD, Ph.D
- E-mail: sgayete@thechr.com
-
Kontakt:
- David H. Barad, MD, MS
- Telefonnummer: 2129944400
- E-mail: dbarad@thechr.com
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
Women eligible for participation in this study will be recruited at the Center for Human Reproduction (CHR) in New York at the Division of Reproductive Endocrinology and Infertility at the University of Miami Miller School of Medicine. Participants must be aged 20-45, have a normal ovarian reserve (≥1.1 ng/mL), and a history of poor oocyte quality observed in at least one prior IVF cycle, defined as:
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<50% maturity rate and/or <50% IVM rate and/or <70% fertilization rate
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Poor embryo quality, defined as:
- Age 20-37 years: >50% day-3 embryos poorer than 7C4
- Age 38-45 years: >50% day-3 embryos poorer than 6C3
In addition, inclusion criteria are:
- Known or unknown etiology of poor oocyte quality;
- Normal 46XX karyotype;
- Agreement to be monitored and treated as per the study protocol
Exclusion Criteria:
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Diminished ovarian reserve (AMH <1.1 ng/mL)
-
Poor response to prior ovarian stimulation, defined as:
- Age 20-37 years: < 6 oocytes retrieved in the previous cycle;
- Age 38-45 years: < 4 oocytes retrieved in the previous cycle;
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Severe male factor
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Karyotype abnormalities
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Ovarian priming
This is a prospective, single-arm, stratified pilot study with two prespecified age strata: Age 20-37 -No Qualifying embryos AND Age 38-45 -No Qualifying embryos. A total of 20 participants will be enrolled at the CHR, 10 per age stratum. |
Ovarian priming with Sirolimus 1 mg orally daily in late luteal phase (from cycle-day 19-21 until menstrual period, hence for a total of 7-10 days), immediately preceding ovarian stimulation for embryo banking and later embryo transfer (after at least 12 weeks). |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Responder vs. non-responder to rapamycin priming
Tidsramme: Ovarian priming 7-10 days, immediately preceding ovarian stimulation for embryo banking and later embryo transfer (after at least 12 weeks)
|
Binary outcome defined as responder vs. non-responder to rapamycin priming in the post-intervention cycle. A "responder" is defined as achieving at least one Day-3 embryo that meets the prespecified qualifying embryo criteria outlined below.
|
Ovarian priming 7-10 days, immediately preceding ovarian stimulation for embryo banking and later embryo transfer (after at least 12 weeks)
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Number of qualifying Day-3 embryos per cycle, distribution of Day-3 cell number and combined morphology grades
Tidsramme: Ovarian priming 7-10 days, immediately preceding ovarian stimulation for embryo banking and later embryo transfer (after at least 12 weeks)
|
• And if available: Day-5 development metrics and clinical outcomes (reported descriptively only) |
Ovarian priming 7-10 days, immediately preceding ovarian stimulation for embryo banking and later embryo transfer (after at least 12 weeks)
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 0205206-04
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