NCT02867111

Brief Summary

Infertility is considered a disease by the World Health Organization and it is increasing worldwide affecting more than 70 million couples. About 50% of the cases are due to male inability to fertilize the oocyte. In the last 40 years, several techniques, known as Assisted Reproduction Technology (ART) have been developed to treat infertility, but the efficiency is still relatively low (around 30%) whereas the remaining 70% attempts again several times, an expensive and emotionally moving treatment. Over 4million of infertility treatments are practiced around the world per year and a 50% increment is expected over the next 6years. Even though ART allows the birth of babies that would be impossible under natural circumstances, it is still necessary to improve the procedures in order to increase treatment efficiency. The success of ART depends, to some extent, on sperm quality. Indeed, the relevance of spermatozoa quality is notorious even beyond fertilization, extending to embryo development and implantation. In this context, it has been developed a new technology that allows the selection of those spermatozoa at their best functional state (Sperm Selection Assay, SSA; Patent approved for USA and Europe, pending for Japan and Argentina). This method is based on the attraction of spermatozoa ready to fertilize the egg, towards a physiological attractant molecule. The SSA may be applied to improve diagnosis and infertility treatment. The investigators hypothesis states that the use of the SSA will improve the number of good-quality embryos which are the ones to be transferred by intracytoplasmic sperm injection (ICSI), providing a healthy embryo development. The protocol involves three experimental groups where the SSA will be used or not, before performing the ICSI: 1)SSA containing the sperm attractant molecule, 2)SSA without the attractant molecule, and 3)without SSA. The patient inclusion criteria involve female factors associated to tubal obstruction and/or endometriosis and male factors associated to sperm disability. Several outcome parameters will be determined, the percentage of fertilization, embryo quality, rate of pregnancy and rate of birth. The study will be carried out in the Universitarian Institute of Reproductive Medicine (IUMER) which has been recently established in a public hospital depending on the National University of Córdoba, offering free high complexity infertility treatment to patients without health insurance or economic support

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
150

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Aug 2016

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 1, 2016

Completed
Same day until next milestone

Study Start

First participant enrolled

August 1, 2016

Completed
14 days until next milestone

First Posted

Study publicly available on registry

August 15, 2016

Completed
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2020

Completed
Last Updated

November 13, 2019

Status Verified

November 1, 2019

Enrollment Period

4.3 years

First QC Date

August 1, 2016

Last Update Submit

November 11, 2019

Conditions

Keywords

sperm selectionICSIAssisted Reproductive Techniques

Outcome Measures

Primary Outcomes (1)

  • Fertilization rate

    Fertilization rate= number of fertilized oocyte (oocytes with 2 pronuclei) / Total of injected oocytes in metaphase II

    within 24 hs

Secondary Outcomes (14)

  • Embryo quality

    within 48 to 66hs post injection

  • Transferable embryo rate

    within 72hs post injection

  • Pregnancy rate

    within 30 days post injection

  • Birth rate

    Up to 42 weeks after positive implantation

  • Implantation yield

    72 hs post injection

  • +9 more secondary outcomes

Study Arms (3)

ICSI Control

OTHER

Intracytoplasmic sperm injection (ICSI), an in vitro fertilization procedure in which a single sperm is injected directly into an egg, with no intervention of the Sperm Selection Assay

Procedure: ICSI

ICSI + SSA placebo

PLACEBO COMPARATOR

Intracytoplasmic sperm injection (ICSI), an in vitro fertilization procedure in which a single sperm is injected directly into an egg, with intervention of the Sperm Selection Assay with control solution (culture medium)

Device: Sperm Selection AssayProcedure: ICSI

ICSI + SSA Attractant substance

EXPERIMENTAL

Intracytoplasmic sperm injection (ICSI), an in vitro fertilization procedure in which a single sperm is injected directly into an egg, with intervention of the Sperm Selection Assay with attractant solution (attractant diluted in culture medium at 10 pM)

Device: Sperm Selection AssayOther: Attractant SubstanceProcedure: ICSI

Interventions

Sperm Selection Assay (SSA) that allow the investigators to select functional spermatozoa, which are capacitated, with intact DNA, reduced oxidative stress and with good viability and motility, on the basis of sperm chemotaxis towards a physiological attractant molecule.

Also known as: SSA
ICSI + SSA Attractant substanceICSI + SSA placebo

Capacitated spermatozoa may be oriented by following an increasing concentration gradient of an attractant molecule, a phenomenon called sperm chemotaxis. This is a guidance mechanism observed in vitro, which may transport and retain spermatozoa at the fertilization site. Though several molecules have been suggested to attract human spermatozoa, in the context of gamete interaction prior to fertilization, progesterone has biological importance for several reasons. After ovulation, this hormone is secreted by the cumulus cells that surround the oocyte, diffusing to form a molecular gradient toward the periphery of the cumulus and beyond. Notably, a gradient of very low concentrations (picomolar) of progesterone is sufficient to chemically attract capacitated human spermatozoa

ICSI + SSA Attractant substance
ICSIPROCEDURE

An in vitro fertilization procedure in which a single sperm is injected directly into an egg

Also known as: Intracytoplasmatic Sperm Injection
ICSI + SSA Attractant substanceICSI + SSA placeboICSI Control

Eligibility Criteria

Age18 Years - 50 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Clinical diagnosis for primary and secondary infertility
  • Healthy females or females with tubal obstruction (uni or bilateral) and/or endometriosis.
  • Clinical diagnosis for unexplained infertility.
  • Females between 18 and 40 years old.
  • Healthy males between 18 and 50 years old.
  • Males with oligozoospermia, teratozoospermia, asthenozoospermia or asthenoteratozoospermia.

You may not qualify if:

  • Low complexity assisted reproductive techniques
  • In vitro fertilization treatment
  • Males with oligoasthenoteratozoospermia and oligoasthenozoospermia.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

HALITUS Instituto Médico

Buenos Aires, Buenos Aires F.D., 1414, Argentina

RECRUITING

Instituto Universitario de Medicina Reproductiva (IUMER)

Córdoba, Córdoba Province, X5010AWC, Argentina

RECRUITING

MeSH Terms

Conditions

Infertility

Interventions

Sperm Injections, Intracytoplasmic

Condition Hierarchy (Ancestors)

Genital DiseasesUrogenital Diseases

Intervention Hierarchy (Ancestors)

Fertilization in VitroReproductive Techniques, AssistedReproductive TechniquesTherapeuticsInvestigative Techniques

Study Officials

  • Laura C. Giojalas, PhD

    National University of Cordoba

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Laura C Giojalas, PhD

CONTACT

Maria J. Figueras, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, CARE PROVIDER
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD

Study Record Dates

First Submitted

August 1, 2016

First Posted

August 15, 2016

Study Start

August 1, 2016

Primary Completion

December 1, 2020

Study Completion

December 1, 2020

Last Updated

November 13, 2019

Record last verified: 2019-11

Data Sharing

IPD Sharing
Will not share

Locations