Infertility Clinical Trial
Official title:
Improvement of IVF Fertilization Rates, by the Cyclic Tripeptide FEE - Prospective Randomized Study
cFEE peptide improves the IVF fertilization rate in mouse and fertilization index in human.
It improves sperm movement's parameters.
It has been studied over 3 generations of mice and appears without any side effects. The
Agence de la BioMédecine has given the authorization for testing the peptide in human IVF.
It is expected to improve the fertilization rate, and thus provide more embryos per IVF
attempt.
160 couples will be included over 15 months. Patient sperm parameters should be suitable for
IVF. Female should be between 18 and 43 year old. Each cohort of eggs will be randomly
distributed to one of the 2 groups The first group will be inseminated with 100000/ml motile
spermatozoa. The second will be similarly inseminated but in a middle which will be
supplemented with cFEE 100µM.
Criteria: number of embryos in each group
Name and address of the coordinating investigator : Prof. Jean Philippe Wolf, Histology -
Embryology Department , Biology of Reproduction - . Cochin Hospital , 123 Bd Port Royal,
75014 Paris Promotor: AP- HP represented by DRCD - Hôpital Saint- Louis Inclusion Sites : CHU
Cochin, Paris
Main objective:
- To improve fertilization rate in IVF by supplementation of culture media with a molecule
increasing the sperm fertilizing ability.
Secondary objectives
- Compare the rates of cleavage between the two groups of zygotes
- Compare the percentage of good quality embryos
Number of patients : 160 Duration of the inclusion period : 15 months Duration of
participation of the patient: For each couple, the duration of participation will be as many
times nine months that pregnancies will be obtained from fresh or frozen embryo transfers.In
the absence of pregnancy duration of participation will be only 15 days.
Time monitoring of children : 9 months
Total study duration : The total study duration will be 36 months
Rational :
The cyclic tripeptide FEEc reproduces the binding site of Fertilin Beta. It binds to the
alpha 6 beta 1 integrin and increases sperm fertilizing ability, improving its movement's
parameters . Added to insemination IVF media, it should increase fertilization rates .
Methodology:
Oocytes in each cohort will be divided into two groups, one of which will be inseminated with
the control medium and the other group is inseminated in the presence of peptide. The
fertilization rate and embryo quality will be compared between these two groups.
Statistical analysis:
In mice with healthy gamete, the observed fertilization rate increase in the presence of
peptide was 100 %. The fertilization rate in human IVF is about 65%, male indications
included. There is an improvement of the fertilization index of zona free human oocytes of
about 90% . We can reasonably foresee an improvement of 15 % of the fertilization rate in
normal IVF.
This is why we believe that the difference between fertilization rates of both treated and
control groups must be meaningful for 160 attempts. In this calculation it was assumed that
the intra cluster correlation (ie intra cohort oocyte ) resulted in a 'design effect' D equal
to 4.
The analysis will include descriptive statistics for each quantitative parameter at each time
: mean, standard deviation , minimum, maximum , median and quartiles , number of missing
values . Quality parameters will be expressed by their frequency of distribution and
associated 95% bilateral confidence intervals.The distributions of the numbers of blastomeres
per embryo will be compared between the two groups by exact permutation test (stratified).
This method is more suitable than "naive" comparison of these numbers, since it takes into
account the possible correlation between results for embryos belonging to the same embryo
cohort (Gibbons JD 1985 Non parametric statistical inference - Marcel Dekker New York ). The
cellular index, the pregnancy rate, spontaneous abortions, therapeutic abortion, childbirth,
will be compared using Student's t test and exact Fisher test. All tests will be bilateral,
and look for possible negative effects, set at 5%. Calculations will be performed using SAS
statistical software v9.13 (SAS Institute, Cary , NC) under the supervision of Professor Eric
Vicaut URC Lariboisière St. Louis.
Primary endpoint : Rate of fertilization Expected Benefits : Improved fertilization rates of
at least 15 %
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