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.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Fase 4
Contacten en locaties
Studiecontact
Studiecontact
- Naam: David H. Barad, MD, MS
- Telefoonnummer: 212-994-4400
- E-mail: dbarad@thechr.com
Studie Contact Back-up
- Naam: Sonia Gayete Lafuente, MD, Ph.D
- E-mail: sgayete@thechr.com
Studie Locaties
-
-
New York
-
New York, New York, Verenigde Staten, 10021
- Werving
- The Center for Human Reproduction
-
Contact:
- Sonia Gayete Lafuente, MD, Ph.D
- E-mail: sgayete@thechr.com
-
Contact:
- David H. Barad, MD, MS
- Telefoonnummer: 2129944400
- E-mail: dbarad@thechr.com
-
-
Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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:
-
<50% maturity rate and/or <50% IVM rate and/or <70% fertilization rate
-
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:
-
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;
-
Severe male factor
-
Karyotype abnormalities
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
|
Experimenteel: 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). |
Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Responder vs. non-responder to rapamycin priming
Tijdsspanne: 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)
|
Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Number of qualifying Day-3 embryos per cycle, distribution of Day-3 cell number and combined morphology grades
Tijdsspanne: 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)
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Medewerkers
Medewerkers
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
Andere studie-ID-nummers
- 0205206-04
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
product vervaardigd in en geëxporteerd uit de V.S.
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .