NCT05240469

Brief Summary

Intracytoplasmic sperm injection (ICSI) is one of the standard clinical treatments for infertility. ICSI involves the injection of a single sperm into an oocyte with a sharp micropipette. Injecting a sperm with DNA fragmentation (i.e., physical breakage of the DNA double strands) into the oocyte deterministically lowers the IVF fertilization rate \[1\]\[2\] and increases the miscarriage rate \[3\]\[4\]. Since the invention of ICSI in 1992, single sperm selection in ICSI has been made manually by embryologists, who select sperm by qualitatively choosing sperm with "good" motility and/or morphology based on their empirical experience. This involves significant subjectivity and inconsistency. We have developed a robotic system to select sperm with low sperm DNA fragmentation. Automated sperm selection also eliminates the subjectivity and inconsistency in manual sperm selection. The system consists of a camera to acquire images of sperm and a software to analyze the images. Embryologists select sperm by observing the same sperm characteristics as in the software criteria (e.g., speed etc.), but the software provides a more accurate and quantitative measure of sperm characteristics, thus ensuring the selected sperm have low DNA fragmentation.

Trial Health

57
Monitor

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
330

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jan 2021

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

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

Study Start

First participant enrolled

January 20, 2021

Completed
9 months until next milestone

First Submitted

Initial submission to the registry

October 15, 2021

Completed
4 months until next milestone

First Posted

Study publicly available on registry

February 15, 2022

Completed
2.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 30, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 30, 2024

Completed
Last Updated

March 4, 2024

Status Verified

March 1, 2024

Enrollment Period

3.7 years

First QC Date

October 15, 2021

Last Update Submit

March 1, 2024

Conditions

Keywords

In Vitro FertilizationEmbryologyOocyteSpermAutomated Sperm SelectionDNA Fragmentation Index

Outcome Measures

Primary Outcomes (3)

  • Fertilization rate

    Fertilization is defined as the visualization of 2 pronuclear at day 1 post ICSI. The proportion of fertilized eggs for each patient will be calculated as fertilization rate. Each patient's data will be aggregated to calculate the overall fertilization rate for all patients.

    1 day

  • Blastocyst formation rate

    The proportion of fertilized embryos classified as blastocysts at day 5 or day 6 of development.

    5 or 6 days

  • Embryo morphology grade as evaluated by the SART grading system

    The morphology grade (good, fair, poor) for each embryo will be evaluated. Grades for all embryos of each patient will be summarized.

    5 or 6 days

Secondary Outcomes (3)

  • Differences in early embryo cleavage divisions and late developmental (blastocyst) morphokinetics.

    5 or 6 days

  • Differences in the proportion of euploid and aneuploid embryos between the two groups

    5 or 6 days

  • Evaluation of patient demographic and stimulation cycle characteristics for confounding variables.

    5 or 6 days

Study Arms (2)

Standard sperm selection

NO INTERVENTION

In the control group the oocytes will be injected with sperm that is selected by embryologists using conventional methods in the IVF lab.

Automated sperm selection

EXPERIMENTAL

The only intervention is the additional sperm selection step using software immediately prior to ICSI.

Device: Automated sperm selection software

Interventions

The software measures both morphology and motility similar to an embryologist but provides a more accurate and consistent measure of sperm characteristics. Embryologists use their experience to qualitatively judge if an individual sperm is "suitable for injection" based on morphology and motility. Similarly, the software follows a two-step process: firstly, a computer vision algorithm measures characteristics of all sperm in a given field, including motility and morphology; secondly, the software algorithm then uses a set of quantitative criteria to categorize and identify the most developmentally competent sperm with normal characteristics. All the characteristics that the software calculate are defined by the WHO guidelines, and the software does not propose or define new parameters.

Automated sperm selection

Eligibility Criteria

Age19 Years - 43 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Patients undergoing ICSI
  • Female partner between 19-43 years of age using own or donor oocytes

You may not qualify if:

  • Patients who do not provide informed consent
  • Patients with less than 6 mature eggs collected
  • Patients undergoing IVF without ICSI
  • Morphology \<4% normal forms
  • % immotile sperm
  • Cases where surgically-retrieved sperm is used for ICSI

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

CReATe Fertility Centre

Toronto, Ontario, M5G 1N8, Canada

RECRUITING

MeSH Terms

Conditions

Infertility

Condition Hierarchy (Ancestors)

Genital DiseasesUrogenital Diseases

Study Officials

  • Yu Sun, PhD

    University of Toronto

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Clifford L Librach, MD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
CARE PROVIDER
Purpose
BASIC SCIENCE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 15, 2021

First Posted

February 15, 2022

Study Start

January 20, 2021

Primary Completion

September 30, 2024

Study Completion

September 30, 2024

Last Updated

March 4, 2024

Record last verified: 2024-03

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