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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT06261671
Other study ID # 2312-ABU-028-VF
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date March 1, 2024
Est. completion date December 31, 2024

Study information

Verified date February 2024
Source ART Fertility Clinics LLC
Contact Daniela Nogueira
Phone +971504374961
Email daniela.nogueira@artfertilityclinics.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

One of the most sensible factors in IVF culture conditions is the susceptibility of gametes and embryos to an induced increase in reactive oxidative species (ROS) caused by the artificial environment. This study aims to evaluate the impact of using antioxidant-supplemented media during culture to evaluate embryo ploidy rates in a prospective randomized trial using sibling oocytes.


Description:

Improvements in culture conditions is an ongoing process in IVF due to, on one hand, the still lack of knowledge on human embryonic development, and, on the other hand, the frequent need for repeated IVF cycles to achieve an 'implantable' embryo. The main factor for optimizing conditions of an embryo to develop is its microenvironment, mainly the culture media used. One of the most sensible factors in IVF culture conditions is the susceptibility of gametes and embryos to an induced increase in reactive oxidative species (ROS) caused by the artificial environment, as it has been extensively shown in animal models and to a certain extent in humans. A primordial step for improvement is to alleviate an increase in ROS during embryo development. This can be manipulated by means of utilizing a culture media with supplements that can serve as scavengers, leading to an equilibrium between oxidation and reduction of ROS during the culture period. So far, the produced culture media contain low concentrations of limited additives involved in anti-oxidative stress. Recently, a culture medium containing an implementation in higher doses of distinctive elements known to clearly serve as cellular scavengers has been formulated. However, very few human IVF studies have been performed up to date. Our research intends to investigate the incorporation of antioxidant-rich culture media into IVF practices with the primary objective of analyzing its impact on embryo euploidy, as well as the previous culture steps including fertilization and blastocyst developmental rates. This study aims to evaluate the impact of using antioxidant-supplemented media during culture to evaluate embryo ploidy rates in a prospective randomized trial using sibling oocytes.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 500
Est. completion date December 31, 2024
Est. primary completion date December 31, 2024
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years to 43 Years
Eligibility Inclusion Criteria: - Patients undergoing assisted reproductive technology cycles when ICSI is indicated. - Patients when Iin vitto fertilization (IVF) is also performed will be included as far as there are enough oocytes for ICSI randomization. However, IVF oocytes will not be used for the study. - Maternal age 18-43 years old. - PGT-A cycles with only trophectoderm biopsies on day 5/6/7. - Patients with more than 6 COCs expected for ICSI. - Body mass index <35. - Fresh and frozen ejaculated sperm. Exclusion Criteria: - PGT-M cycles - Fresh and frozen testicular sperm.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
antioxidants-enriched culture medium (Gx)
Blastocyst will be in continuous culture conditions (parallel antioxidants-enriched culture medium (Gx) and Global total one step media (GT) without refreshment on day 3. A refreshment of the media will be done on D5 in both groups.

Locations

Country Name City State
n/a

Sponsors (1)

Lead Sponsor Collaborator
ART Fertility Clinics LLC

References & Publications (23)

Agarwal A, Rana M, Qiu E, AlBunni H, Bui AD, Henkel R. Role of oxidative stress, infection and inflammation in male infertility. Andrologia. 2018 Dec;50(11):e13126. doi: 10.1111/and.13126. — View Citation

Agarwal A, Said TM. Role of sperm chromatin abnormalities and DNA damage in male infertility. Hum Reprod Update. 2003 Jul-Aug;9(4):331-45. doi: 10.1093/humupd/dmg027. — View Citation

Aitken RJ. Impact of oxidative stress on male and female germ cells: implications for fertility. Reproduction. 2020 Apr;159(4):R189-R201. doi: 10.1530/REP-19-0452. — View Citation

Bedaiwy M, Agarwal A, Said TM, Goldberg JM, Sharma RK, Worley S, Falcone T. Role of total antioxidant capacity in the differential growth of human embryos in vitro. Fertil Steril. 2006 Aug;86(2):304-9. doi: 10.1016/j.fertnstert.2006.01.025. Epub 2006 Jun 12. — View Citation

Carbone MC, Tatone C, Delle Monache S, Marci R, Caserta D, Colonna R, Amicarelli F. Antioxidant enzymatic defences in human follicular fluid: characterization and age-dependent changes. Mol Hum Reprod. 2003 Nov;9(11):639-43. doi: 10.1093/molehr/gag090. — View Citation

Chambers GM, Dyer S, Zegers-Hochschild F, de Mouzon J, Ishihara O, Banker M, Mansour R, Kupka MS, Adamson GD. International Committee for Monitoring Assisted Reproductive Technologies world report: assisted reproductive technology, 2014dagger. Hum Reprod. 2021 Oct 18;36(11):2921-2934. doi: 10.1093/humrep/deab198. — View Citation

Gardner DK, Kuramoto T, Tanaka M, Mitzumoto S, Montag M, Yoshida A. Prospective randomized multicentre comparison on sibling oocytes comparing G-Series media system with antioxidants versus standard G-Series media system. Reprod Biomed Online. 2020 May;40(5):637-644. doi: 10.1016/j.rbmo.2020.01.026. Epub 2020 Feb 5. — View Citation

Guerin P, El Mouatassim S, Menezo Y. Oxidative stress and protection against reactive oxygen species in the pre-implantation embryo and its surroundings. Hum Reprod Update. 2001 Mar-Apr;7(2):175-89. doi: 10.1093/humupd/7.2.175. — View Citation

Halliwell B, Aruoma OI. DNA damage by oxygen-derived species. Its mechanism and measurement in mammalian systems. FEBS Lett. 1991 Apr 9;281(1-2):9-19. doi: 10.1016/0014-5793(91)80347-6. — View Citation

Hardy MLM, Day ML, Morris MB. Redox Regulation and Oxidative Stress in Mammalian Oocytes and Embryos Developed In Vivo and In Vitro. Int J Environ Res Public Health. 2021 Oct 29;18(21):11374. doi: 10.3390/ijerph182111374. — View Citation

Kehrer JP, Lund LG. Cellular reducing equivalents and oxidative stress. Free Radic Biol Med. 1994 Jul;17(1):65-75. doi: 10.1016/0891-5849(94)90008-6. — View Citation

Kiani-Esfahani A, Bahrami S, Tavalaee M, Deemeh MR, Mahjour AA, Nasr-Esfahani MH. Cytosolic and mitochondrial ROS: which one is associated with poor chromatin remodeling? Syst Biol Reprod Med. 2013 Dec;59(6):352-9. doi: 10.3109/19396368.2013.829536. Epub 2013 Aug 22. — View Citation

Lan KC, Lin YC, Chang YC, Lin HJ, Tsai YR, Kang HY. Limited relationships between reactive oxygen species levels in culture media and zygote and embryo development. J Assist Reprod Genet. 2019 Feb;36(2):325-334. doi: 10.1007/s10815-018-1363-6. Epub 2018 Nov 10. — View Citation

Lian HY, Gao Y, Jiao GZ, Sun MJ, Wu XF, Wang TY, Li H, Tan JH. Antioxidant supplementation overcomes the deleterious effects of maternal restraint stress-induced oxidative stress on mouse oocytes. Reproduction. 2013 Oct 21;146(6):559-68. doi: 10.1530/REP-13-0268. Print 2013 Dec. — View Citation

Lu J, Wang Z, Cao J, Chen Y, Dong Y. A novel and compact review on the role of oxidative stress in female reproduction. Reprod Biol Endocrinol. 2018 Aug 20;16(1):80. doi: 10.1186/s12958-018-0391-5. — View Citation

Mauchart P, Vass RA, Nagy B, Sulyok E, Bodis J, Kovacs K. Oxidative Stress in Assisted Reproductive Techniques, with a Focus on an Underestimated Risk Factor. Curr Issues Mol Biol. 2023 Feb 3;45(2):1272-1286. doi: 10.3390/cimb45020083. — View Citation

Meldrum DR, Casper RF, Diez-Juan A, Simon C, Domar AD, Frydman R. Aging and the environment affect gamete and embryo potential: can we intervene? Fertil Steril. 2016 Mar;105(3):548-559. doi: 10.1016/j.fertnstert.2016.01.013. Epub 2016 Jan 23. — View Citation

Pigeolet E, Corbisier P, Houbion A, Lambert D, Michiels C, Raes M, Zachary MD, Remacle J. Glutathione peroxidase, superoxide dismutase, and catalase inactivation by peroxides and oxygen derived free radicals. Mech Ageing Dev. 1990 Feb 15;51(3):283-97. doi: 10.1016/0047-6374(90)90078-t. — View Citation

Ruder EH, Hartman TJ, Blumberg J, Goldman MB. Oxidative stress and antioxidants: exposure and impact on female fertility. Hum Reprod Update. 2008 Jul-Aug;14(4):345-57. doi: 10.1093/humupd/dmn011. Epub 2008 Jun 4. — View Citation

Ruder EH, Hartman TJ, Goldman MB. Impact of oxidative stress on female fertility. Curr Opin Obstet Gynecol. 2009 Jun;21(3):219-22. doi: 10.1097/gco.0b013e32832924ba. — View Citation

Truong T, Gardner DK. Antioxidants improve IVF outcome and subsequent embryo development in the mouse. Hum Reprod. 2017 Dec 1;32(12):2404-2413. doi: 10.1093/humrep/dex330. — View Citation

Van Montfoort APA, Arts EGJM, Wijnandts L, Sluijmer A, Pelinck MJ, Land JA, Van Echten-Arends J. Reduced oxygen concentration during human IVF culture improves embryo utilization and cumulative pregnancy rates per cycle. Hum Reprod Open. 2020 Jan 22;2020(1):hoz036. doi: 10.1093/hropen/hoz036. eCollection 2020. — View Citation

von Mengden L, Klamt F, Smitz J. Redox Biology of Human Cumulus Cells: Basic Concepts, Impact on Oocyte Quality, and Potential Clinical Use. Antioxid Redox Signal. 2020 Mar 10;32(8):522-535. doi: 10.1089/ars.2019.7984. — View Citation

* Note: There are 23 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Blastocyst ploidy is determined after a biopsy of trophectoderm cells, taken from the blastocyst on day 5, 6 or 7 from development. The following outcomes are possible: • Normal • Abnormal • No result/Inconclusive • Low or high Mosaic Ploidy rate is calculated by dividing the number of normal embryos by the number of blastocysts biopsied in the group. 1 year
Secondary Cycle ploidy rate: the number of euploid embryos in the group Blastocyst quality at the time of biopsy based on modified Gardner's criteria. Usable blastocyst rate per group and per day of biopsy (day 5, 6, 7) Ploidy rate is calculated by dividing the number of normal embryos by the number of blastocysts biopsied in the group. 1 year
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