Premature Ovarian Failure Clinical Trial
Official title:
Safety and Feasibility Study of Intra-ovarian Injection of Bone Marrow Mesenchymal Stromal Cells-derived Extracellular Vesicles in Idiopathic Premature Ovarian Failure Patients: Clinical Trial Phase I
Premature ovarian failure (POF) is a clinical syndrome defined by loss of ovarian activity before the age of 40 years. POF is characterized by menstrual disturbance (amenorrhea or oligomenorrhea) with raised gonadotrophins and low estradiol. The prevalence of POF is 1-2%. Extracellular vesicles (EVs) are membrane-packed vesicles that are secreted by a variety of cell types, including T cells, B cells, dendritic cells, platelets, mast cells, epithelial cells, endothelial cells, neuronal cells, cancerous cells, oligodendrocytes, Schwann cells, embryonic cells, and mesenchymal stromal cells-derived (MSCs). MSCs-EV more stable and induce stronger signaling and are produced in higher concentrations than stem cells. They demonstrate no inherent toxicity, are not associated with any long-term maldifferentiation of engrafted cells or tumor generation, and carry no apparent risk of aneuploidy or immune rejection following in vivo allogenic administration.Several studies have evaluated the safety and possible efficacy of injection MSCs-EV for the treatment of premature ovarian failure in animal models. Based on the available evidence, the study was designed with the aim of investigating the safety and effectiveness of intraovarian injection of MSCs-EV in patients with POF diagnosis.
Status | Recruiting |
Enrollment | 10 |
Est. completion date | February 18, 2025 |
Est. primary completion date | September 20, 2024 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 20 Years to 38 Years |
Eligibility | Inclusion Criteria: - Women between 20-38 years old - Baseline serum level of follicle stimulating hormone (FSH) higher or equal to 25 IU/l at least twice with an interval of 3 or 4 months - At least one year has passed since secondary amenorrhea and premature ovarian failure (POF) diagnosis - Normal karyotype and fragile X messenger ribonucleoprotein 1 (FMR1) gene Exclusion Criteria: - Primary amenorrhea - Congenital anomaly of the ovary - Thyroid disease Immune system diseases such as lupus, etc. - Previous and/or family history of ovarian tumor - Previous and/or family history of suffering from major diseases in the past and present such as cancer - Positive serological evidence regarding previous or current hepatitis B and C, Human T-lymphotropic virus 1, Human immunodeficiency virus (HIV), Syphilis Disturbance in the normal range of laboratory tests as levels of Hemoglobin Subunit Alpha 1 (HbA1), Alanine transaminase (ALT), The aspartate aminotransferase (AST), the number of white blood cells (WBCs), The creatinine (Cr), International normalised ratio (INR) , Platelets (Plt), Hematocrit (Hct) tests. - History of specific systemic disease (rheumatology, endocrine, cardiovascular, etc.) - Severe endometriosis (stage III and IV) - Small and non-injectable ovaries Lack of patient satisfaction - The patient's unwillingness to continue participating in the study |
Country | Name | City | State |
---|---|---|---|
Iran, Islamic Republic of | Royan Institute | Tehran |
Lead Sponsor | Collaborator |
---|---|
Royan Institute |
Iran, Islamic Republic of,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Rate of ovary abscess | Sonographic evaluation of ovaries will be done for detection of ovarian abscess or any other ovarian lesion formation up to 8 months after intraovarian injection of extracellular vesicles derived from bone marrow mesenchymal stromal cells (any adverse events through follow-up visits (first 24 hours and first week after transplantation, 1, 2, 3, 4, 5, 6, 7 and 8 months after injection) will be checked and recorded. | First 24 hours, first week and monthly up to 8 months after injection | |
Secondary | Basal follicle-stimulating hormone (FSH) serum level | Hormonal examination will be done with standard methods in the specialized laboratory of Royan Institute. A venous blood sample will be collected from all participants. The basal serum levels of FSH will be measured by Electrochemiluminescence immunoassay (ECLIA) using fully automated COBAS E-601 analyzer and a commercial kit (Roche Diagnostics GmbH, Mannheim, Germany). The Units of Measure will be presented as IU/l. | Baseline,1 week as well as one, two, three, four , five, six, seven and eight months after transplantation | |
Secondary | Serum anti-mullerian hormone (AMH) levels | Hormonal examination will be done with standard methods in the specialized laboratory of Royan Institute. A venous blood sample will be collected from all participants. The basal serum levels of AMH will be measured by Electrochemiluminescence immunoassay (ECLIA) using fully automated COBAS E-601 analyzer and a commercial kit (Roche Diagnostics GmbH, Mannheim, Germany). The Units of Measure will be presented as ng/ml. | Before the intervention (baseline) and also three, six and eight months after transplantation | |
Secondary | Menstruation recurrence rate | Through monthly follow-up and asking the questions.The number of patients whose menstrual cycle has returned will be reported. | one, two, three, four , five, six, seven and eight months after transplantation | |
Secondary | Antral follicle count | Through monthly examination of specialized ultrasonography.The number of follicles measuring 2-10 mm in diameter observed in each ovary will be counted and recorded in the ultrasound examination. | Before the intervention (baseline) as well as one, two, three, four , five, six, seven and eight months after transplantation | |
Secondary | The ovaries size and volume | The Ovary size and volume will be determined through monthly examination of specialized ultrasonography. The volume estimate is calculated by the formula for an ellipsoid, where D1, D2, and D3 are the three axial measurements:
D1 x D2 x D3 x 0.52 |
One, two, three, four , five, six, seven and eight months after transplantation |
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