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.
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Studietype
Studietype
Registrering (Antatt)
Registrering
Fase
Fase
- Fase 4
Kontakter og plasseringer
Studiekontakt
Studiekontakt
- Navn: David H. Barad, MD, MS
- Telefonnummer: 212-994-4400
- E-post: dbarad@thechr.com
Studer Kontakt Backup
- Navn: Sonia Gayete Lafuente, MD, Ph.D
- E-post: sgayete@thechr.com
Studiesteder
-
-
New York
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New York, New York, Forente stater, 10021
- Rekruttering
- The Center for Human Reproduction
-
Ta kontakt med:
- Sonia Gayete Lafuente, MD, Ph.D
- E-post: sgayete@thechr.com
-
Ta kontakt med:
- David H. Barad, MD, MS
- Telefonnummer: 2129944400
- E-post: dbarad@thechr.com
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
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)
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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 studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
|
Eksperimentell: 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). |
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
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 |
Tiltaksbeskrivelse |
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)
|
Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Samarbeidspartnere
Samarbeidspartnere
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Studiestart
Primær fullføring (Antatt)
Primær fullføring
Studiet fullført (Antatt)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
Andre studie-ID-numre
- 0205206-04
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