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Intrauterine Insemination In HIV-Discordant Couples (ARTEMIS)

19. februar 2016 opdateret af: Boston Medical Center
This study aims to assess the feasibility of a novel standard of care technique for intrauterine insemination (IUI) in HIV-discordant couples in the United States. This study will involve couples in which the male partner is HIV positive, but the female partner is negative. The investigators will institute a protocol similar to those used presently throughout Europe with good success. To date, no HIV seroconversions have occurred in over 4000 inseminations performed in HIV serodiscordant couples. All male subjects will be on stable HAART, and have undetectable serum viral loads prior to insemination. Semen samples will be subjected to a stringent sperm wash procedure and screened for HIV RNA. Female subjects will be followed post-insemination for seroconversion and pregnancy. Infants will be followed for seroconversion at birth through 4 months of age.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This study aims to assess the feasibility of a novel standard of care technique for intrauterine insemination (IUI) in HIV-discordant couples in the United States. This study will involve couples in which the male partner is HIV positive, but the female partner is negative.

The investigators will institute a protocol similar to those used presently throughout Europe with good success. To date, no HIV seroconversions have occurred in over 4000 inseminations performed in HIV serodiscordant couples.

All male subjects will be on stable HAART and have undetectable serum viral loads prior to insemination. For semen samples, seminal fluid will be separated from sperm using a density gradient/swim-up separation technique. The purified sperm sample will be washed, and screened for HIV RNA using sensitive real-time RT-PCR. Samples with detectable traces of HIV RNA will not be used for insemination. Samples with no detectable traces of HIV RNA will be used for a standard intrauterine insemination of the female partner.

Female subjects will be followed post-insemination for seroconversion and pregnancy. Infants will be followed for seroconversion at birth through 3 months of age.

The data being collected in this pilot feasibility study will be mostly descriptive, lacking sample size to achieve statistical power for testing. However, the investigators will use case-control analysis to compare couples who achieve pregnancy with those who do not across demographics and markers of HIV disease progression. Additionally, the investigators have developed a 14 item, 5-point Likert scale to assesses the psychosocial impact of reproductive health issues stemming from HIV-discordance in both the female and male participants.

The expected duration for any unique subject couple is 3 to 12 months, depending on pregnancy. It is expected that the interventional portion of this study will continue for up to 2 years, depending on pregnancies.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

10

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02118
        • Boston Medical Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 50 år (Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Couples with HIV discordance with an HIV seronegative female partner and HIV seropositive male partner
  • Men must be HIV positive with an undetectable viral load (<75 copies/ml)
  • Men must be clinical stable on antiretroviral therapy for 6 months
  • Men must have a CD4 count > 250 at screening
  • Men must be between 18-50 years of age
  • Men must have a baseline test sperm preparation demonstrating at least 10 million motile sperm per sample
  • Men must have a letter of medical clearance specific for this procedure from primary care physician stating that subject is in good health and psychologically stable
  • Men must be willing to have constituent follow-up of HIV care throughout study participation
  • Women must have an HIV-1/HIV-2 negative serology at screening
  • Women must be between 18-40 years of age
  • Women must have a body mass index (BMI) less than 30
  • Women must be a non-smoker
  • Women must be ovulatory (as determined by LH tracking)
  • Women must have normal uterine cavity with at least one documented patent fallopian tube (as determined by hysterosalpingogram)
  • Women must have adequate day 3 ovarian reserves: FSH,12 mlU/ml and estradiol<80pg/ml
  • Women must have no evidence of active urogenital infection at screening
  • Women must have a normal PAP smear and GC/Chlamydia at screening
  • Women must have a letter of medical clearance specific to this procedure from subject's primary care physician stating that subject is in good health and psychological stable.

Exclusion Criteria:

  • Subjects with untreated sexually transmitted diseases (syphilis, GC, CT)
  • Men with detectable viral load (>75) at screening
  • Subjects with any condition (including, but not limited to alcohol and drug use), which, in the opinion of the investigator, could compromise the subject's safety or adherence to the protocol
  • Subjects with any uncontrollable medical or psychiatric condition that,in the opinion of the investigator, cannot be adequately stabilized and could be considered a contraindication to participation

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Pregnancy
Tidsramme: Sixteen days after IUI
A serum pregnancy test will be performed 16 days after IUI if menses is missed.
Sixteen days after IUI

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Post-IUI HIV Infection of Female Subject
Tidsramme: Four weeks after IUI
The female subject will be tested for HIV by branch-DNA (b-DNA) test four weeks after each insemination.
Four weeks after IUI
Female Subject HIV-1/HIV-2 Serology
Tidsramme: Three, six, nine (pregnant only) and twelve months after insemination
If the female subject does not become pregnant, she will be tested for HIV-1/HIV-2 serology at 3 months, 6 months and 12 months after the insemination. If repeat inseminations are performed, the above-stated timeline will be followed based on the last insemination performed. If the female subject does become pregnant, she will be tested for HIV-1/HIV-2 serology at 3 months, 6 months and 9 months after the insemination, and again at 3 months postpartum.
Three, six, nine (pregnant only) and twelve months after insemination
Infant HIV-1/HIV-2 Serology
Tidsramme: Three months of age
For a successful birth, the infant will undergo an HIV-1/HIV-2 serology test at three months of age.
Three months of age

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Boston Medical Center

Efterforskere

  • Ledende efterforsker: Margaret M Sullivan, MD, Boston Medical Center

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. september 2009

Primær færdiggørelse (Faktiske)

1. september 2012

Studieafslutning (Faktiske)

1. oktober 2013

Datoer for studieregistrering

Først indsendt

28. juli 2010

Først indsendt, der opfyldte QC-kriterier

30. juli 2010

Først opslået (Skøn)

2. august 2010

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

22. februar 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

19. februar 2016

Sidst verificeret

1. januar 2012

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • ARTEMIS

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Sperm Washing with Intrauterine Insemination (IUI)

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Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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