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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT06210451
Other study ID # 0147-23-WOMC
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date February 1, 2024
Est. completion date December 31, 2026

Study information

Verified date January 2024
Source Wolfson Medical Center
Contact Daniel Tairy, MD
Phone +972-54-5315875
Email danieltairy1@gmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Lubrication gels are widely used in numerous gynecologic procedures in order to ease the insertion of speculum and visualize the cervix. It was shown that applying lubricating gels significantly decreases patient pain during vaginal speculum examination. While many fertility specialists use lubrication gels to insert the speculum during embryo transfer (ET), others are strongly reluctant to use gels due to concern that they might have a detrimental effect on embryos and ET success. Similar concern was prevalent regarding the use of lubrication gel during Pap-smear for detection of cervical dysplasia. However, several studies have shown that the use of small amount of water-soluble gel does not change cervical cytology. Lubrication gels might have deleterious effect on sperm motility. However, to the best of our knowledge, there wasn't any study examining the effect of lubricant gel on ET success. Our hypothesis is that using a lubrication gel will not reduce the live birth rate per transfer, but decrease patient pain during procedure.


Description:

In vitro fertilization (IVF) involves a highly complex series of events leading to the creation of an embryo. The transfer of that embryo, the final step in the process, is seen as a critical moment at the culmination of this incredibly intricate process. The technique of the embryo transfer (ET) has undergone a slow evolution, but for many physicians, this step remains relatively consistent throughout years of practice. While the procedure itself is relatively short, physicians often have specific preferences for each of the steps involved, either supported by evidence, learned from mentors or guided by experience and individual success. As such, ET success rates are a statistic that generates significant pride among physicians and are often tracked by clinics as a quality control metric. Interestingly, there are significant outcome differences between physicians. Numerous techniques and practices employed during ET have been studied. For some, the evidence is robust, while for others, it is very limited. Some practices and techniques were found to improve ET success, such as: abdominal US guidance, removal of cervical mucus, use of a soft catheter, and placement of the embryo at a distance of more than 10 mm from the uterine fundus. For other aspects of ET there is no sufficient evidence to decide on the preferred practice. These include the optimal length of the procedure and rotation of the catheter during withdrawal. Good-quality randomized clinical trials are much needed in order to decide on the best practice. For example, there was previously a concern that the use of powdered gloves during ET might be toxic to the embryos. However, a single RCT (n=712) has shown that using powdered gloves resulted in similar pregnancy rates compared to unpowdered gloves. Lubrication gels are widely used in numerous gynecologic procedures in order to ease the insertion of speculum and visualize the cervix. It was shown that applying lubricating gels significantly decreases patient pain during vaginal speculum examination. While many fertility specialists use lubrication gels to insert the speculum during ET, others are strongly reluctant to use gels due to concern that they might have a detrimental effect on embryos and ET success. Similar concern was prevalent regarding the use of lubrication gel during Pap-smear for detection of cervical dysplasia. However, several studies have shown that the use of small amount of water-soluble gel does not change cervical cytology. Lubrication gels might have deleterious effect on sperm motility. However, to the best of our knowledge, there wasn't any study examining the effect of lubricant gel on ET success. Our hypothesis is that using a lubrication gel will not reduce the live birth rate per transfer, but decrease patient pain during procedure.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 416
Est. completion date December 31, 2026
Est. primary completion date December 31, 2026
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Female
Age group 18 Years to 40 Years
Eligibility Inclusion Criteria: - Age 18-40 - Fresh and thawed ET - Patients undergoing their 1st-3rd ET - ET of 1-2 embryos Exclusion Criteria: - Age>40 - Egg donation cycles

Study Design


Related Conditions & MeSH terms


Intervention

Other:
Sterile water-based gel
Insertion of the speculum during ET will be performed using 5 gr of water-based, sterile gel

Locations

Country Name City State
n/a

Sponsors (1)

Lead Sponsor Collaborator
Wolfson Medical Center

Outcome

Type Measure Description Time frame Safety issue
Primary Ongoing pregnancy or live birth rate. Number of patients with ongoing pregnancy or live birth at >20 week's gestation. 3 years
Secondary Positive serum BHCG Number of patients with positive serum BHCG test. 3 years
Secondary Clinical pregnancy Number of patients with transvaginal ultrasound test demonstrating fetal cardiac activity. 3 years
Secondary Questionnaire Pain score on a scale of 1 to 10, where 1 indicates no pain and 10 indicates worst possible pain. 3 years
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