Identifying Disease Mechanisms Underlying the Association Between Asthma and Infertility - The INFLammation Asthma Mechanism Endometrium (INFLAME) Study

Asthma Clinical Trial

— INFLAME  

Official title:

Identifying Disease Mechanisms Underlying the Association Between Asthma and Infertility - The INFLammation Asthma Mechanism Endometrium (INFLAME) Study

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04626557
• Other study ID #: H-20029413
• Status: Recruiting
• Start date: November 2, 2020
• Est. completion date: October 31, 2021

Study information

• Verified date: December 2020
• Source: Hvidovre University Hospital
• Contact: Casper Tidemandsen, MD
• Phone: +4523497817
• Email: casper.tidemanden.02[@]regionh.dk
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

To investigate if asthma affects the inflammatory balance of the endometrium and thereby interfere with implantation, as indicated by the characteristics of the inflammatory cells in the endometrium and airways in women with asthma who are referred for IUI or IVF due to infertility, compared to otherwise healthy women who are referred for IUI or IVF due to infertility.

Description:

The link between asthma and fertility may be associated with widespread tissue inflammation, as inflammatory changes are not only affecting the respiratory organs, but also systemically, and here by affecting both the lungs and the reproductive organs in women with asthma.

A likely mechanism involved in infertility among asthmatic women seems to be inflammatory changes found in the endometrium of the uterus. Some studies show high number of mast cells, eosinophil granulocytes and basophil granulocytes in the endometrium[1]. One study found low values of VEGF in endometrial secretion in women with asthma as a possible cause for subfertility [2]. Others assume, that an imbalance of the adaptive immune system (both the Th1 and Th2/TH17 response) is associated with infertility [3].

It has been shown that inflammation in the endometrium with a specific combination of cytokines and chemokines is part of successful implantation [4]. However, If the inflammatory process is characterized by a less optimal combination of cytokines and chemokines the reproductive outcome may be less successful. The systemic inflammation caused by asthma could offset the balance between the cytokines and chemokines in the endometrium and thereby have negative impact on reproductive outcome.

In the present study, our aim is to analyze inflammation in the uterus and in the airways in women with asthma referred to fertility treatment receiving Intrauterine insemination (IUI) or in vitro fertilization (IVF) to characterize and thereby provide knowledge of the mechanisms underlying the association between asthma and reproductive outcomes.

In an explorative non-randomized study, including 30 participants divided into two groups: 15 women with asthma and 15 non-asthmatic controls. The patients will go through an asthma work-up (diagnosis, allergy, medication, and inflammation). Menstrual blood will be collected at home using the menstrual cup and at the 7th-14th day cycle day, an endometrium sample from the uterus lining will be obtained together with sputum, as indicators of the system inflammation expressed both in the lungs and the uterus, and blood samples.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 30
• Est. completion date: October 31, 2021
• Est. primary completion date: September 30, 2021
• Gender: Female
• Age group: 18 Years to 40 Years

Eligibility

Inclusion criteria:

Asthma n= 15:

• Informed consent.

• Diagnosis of asthma.

• 18-40 years.

• Referred to Intra Uterine Insemination (IUI) or in vitro fertilization (IVF)

Non-asthmatic n= 15:

• Informed consent.

• 18-40 years.

• Referred to Intra Uterine Insemination (IUI) or in vitro fertilization (IVF)

Exclusion criteria:

Asthma only:

• Other respiratory diseases than asthma.

• Other inflammatory disease or a disease that affects fertility.

• Infections requiring antibiotics or anti-viral treatment within 30 days.

• Current smokers and/or life-time tobacco exposure > 10 pack-years.

• Endometriosis.

• Infertility due to other reasons than male factor, tubal factor or unexplained infertility.

• No pelvic inflammatory disease (PID) within the last 6 months.

• No contraceptive intrauterine device (IUD), or other contraceptive for the last 6 months.

Non-asthmatic controls:

• No respiratory diseases.

• Other inflammatory disease or a disease that affects fertility.

• Infections requiring antibiotics or anti-viral treatment within 30 days.

• Current smokers and/or life-time tobacco exposure > 10 pack-years.

• Endometriosis.

• Infertility due to other reasons than male factor, tubal factor or unexplained infertility.

• No pelvic inflammatory disease (PID) within the last 6 months.

• No contraceptive intrauterine device (IUD), or other contraceptive for the last 6 months.

Related Conditions & MeSH terms

• Asthma
• Infertility
• Infertility, Female
• Inflammation

Intervention

Procedure:
• biopsy
biopsy of the endometrium

Locations

Country	Name	City	State
Denmark	Department of Respiratory Medicine, Hvidovre University Hospital	Copenhagen	Hvidovre

Sponsors (1)

Lead Sponsor	Collaborator
Hvidovre University Hospital

Country where clinical trial is conducted

Denmark, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	type of inflammatory cells	To classify the type of inflammatory cells, (ie. cytokines and inflammatory cells), found in the uterine lining (endometrium) in women with asthma suffering from infertility, compared to non-asthmatic controls.	6 months
Secondary	airway inflammation vs inflammation in the endometrium.	Explore associations between airway inflammation and inflammation in the endometrium.	6 months
Secondary	systemic inflammation vs local inflammation	Explore associations between systemic inflammation and local inflammation	6 months
Secondary	Severity	Differences in local inflammation of the endometrium within different severities/phenotypes of asthma.	6 months