Infertility, Female Clinical Trial
Official title:
Open Randomized Trial of Clinical Efficiency and Safety of Cell Product of Autologous Bone Marrow-derived Mesenchymal Stem Cells for Reparative Treatment of Destructively Changed Endometrium in Patients With Repeated IVF Failures
Investigators will examine safety and efficiency of the cell product of autologous bone marrow-derived mesenchymal stem cells (MSC) for patients with repeated IVF failures and hypoplastic or/and fibrosis process of endometrium
Sixty patients eligible for the study will be divided to two groups (experimental and
control) according to randomization (envelope) procedure in 1:1 ratio.
For patients of the main group bone marrow stem cells will be extracted from the crest of the
ilium using standard methodology. After extraction and cultivation final product of
autologous bone marrow-derived mesenchymal stem cells will be transplanted to endometrial
cavity on menstrual cycle day 5-6. Meanwhile patients will receive three cycles of hormonal
replacement therapy (4 mg Progynova (Bayer Pharma, Germany) daily on menstrual cycle day 5-25
in combination with 20 mg Duphaston (Abbott Healthcare Products, B.V., Netherlands) daily
from day 15 to day 25. On day 20 of hormonal replacement therapy (HRT) of the last (third)
cycle Pipelle-biopsy of endometrium will be performed. Obtained material will be analyzed by
immunohistochemistry with the assessment of estrogen and progesterone receptors, VEGFa,
GM-CSF, CD133+, CD34 and CD56. Ultrasound characteristics of endometrial quality will be
registered on day 9-10 and day 19-21 of every cycle. When morphological and echographic
parameters of endometrium are found satisfactory for embryo transfer, the HRT for endometrial
preparation for frozen/thawed embryo transfer cycle will be initiated. If acceptable
endometrial characteristics are not achieved, patients could be offered to undergo repeated
(not more than 3) transplantation of MSC procedures.
Control group will receive three standard cycles of HRT following hysteroscopy before
frozen/thawed embryo transfer. If endometrial characteristics are found unsatisfactory,
gestational surrogacy might be offered.
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