Expression of Endometrium During Window of Implantation

Unrecognized Condition Clinical Trial

Official title:

To Investigate the Expression of Endometrium During Window of Implantation Between Natural Cycles and Artificial Cycles

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05478616
• Other study ID #: KSVGH22-CT7-07
• Status: Recruiting
• Start date: July 1, 2022
• Est. completion date: December 31, 2024

Study information

• Verified date: July 2022
• Source: Kaohsiung Veterans General Hospital.
• Contact: Li-Te Lin
• Phone: +88673464027
• Email: litelin1982[@]gmail.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The aim of this study was to investigate the expression of endometrium during window of implantation between natural cycles and artificial cycles.

Description:

Due to progress of embryo vitrification in recent years, frozen embryo transfer (FET) of in vitro fertilization (IVF) has already been a world trend. The most used two protocols of FET are natural cycles (NCs) and artificial cycles (ACs). Recent studies showed that IVF outcomes of NCs were superior to ACs. We hypothesized that the result may be because of better endometrial receptivity of NCs compared to ACs. In NCs, no hormonal agents were administrated. Thus, endometrial receptivity was not disturbed by hormone and became better. However, there were few studies to explore the issue. Therefore, the aim of this study was to investigate the expression of endometrium during window of implantation (WOI) between NCs and ACs.

The study will be performed from July 1st, 2022 to December 31th, 2023 in our reproductive center. We plan to enroll 60 infertile women who have underwent IVF cycles and would like to receive endometrial receptivity assay. We divide the participants into two groups, NCs and ACs. In NCs, no hormonal agents will be used. We identify ovulation day via serial hormone data and sample endometrium during WOI (LH surge + 7 days). In ACs, first, estrogen will be given for 10~14 days and then transvaginal sonography will be conducted. When endometrial thickness reaches 8 mm at least, progesterone will be prescribed. Endometrium is sampled during WOI (P4 + 5 days). We will record basic characteristics, infertility history, hormone data, ovarian reserve and endometrial thickness of infertile women in both groups. Endometrial samples will be assessed miRNA, implantation factors, uterine NK cells and T cells in both groups.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 60
• Est. completion date: December 31, 2024
• Est. primary completion date: December 31, 2023
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 30 Years to 44 Years

Eligibility

Inclusion Criteria:

• Age: 30-44 years

• BMI: 18~30 kg/m2

• Implantation failure at least two times

Exclusion Criteria:

• Primary ovarian insufficiency

• Congenital uterine anomaly

• Severe intrauterine adhesion

• Malignancy

• Donor cycle

Related Conditions & MeSH terms

• Unrecognized Condition

Locations

Country	Name	City	State
Taiwan	Kaohsiung Veterans General Hospital	Kaohsiung City

Sponsors (1)

Lead Sponsor	Collaborator
Kaohsiung Veterans General Hospital.

Country where clinical trial is conducted

Taiwan, 

References & Publications (22)

Bellver J, Simón C. Implantation failure of endometrial origin: what is new? Curr Opin Obstet Gynecol. 2018 Aug;30(4):229-236. doi: 10.1097/GCO.0000000000000468. Review. — View Citation

Bergin K, Eliner Y, Duvall DW Jr, Roger S, Elguero S, Penzias AS, Sakkas D, Vaughan DA. The use of propensity score matching to assess the benefit of the endometrial receptivity analysis in frozen embryo transfers. Fertil Steril. 2021 Aug;116(2):396-403. — View Citation

Cozzolino M, Diaz-Gimeno P, Pellicer A, Garrido N. Evaluation of the endometrial receptivity assay and the preimplantation genetic test for aneuploidy in overcoming recurrent implantation failure. J Assist Reprod Genet. 2020 Dec;37(12):2989-2997. doi: 10. — View Citation

Del Carmen Nogales M, Cruz M, de Frutos S, Martínez EM, Gaytán M, Ariza M, Bronet F, Garcia-Velasco JA. Association between clinical and IVF laboratory parameters and miscarriage after single euploid embryo transfers. Reprod Biol Endocrinol. 2021 Dec 14;1 — View Citation

Donoghue JF, Paiva P, Teh WT, Cann LM, Nowell C, Rees H, Bittinger S, Obers V, Bulmer JN, Stern C, McBain J, Rogers PAW. Endometrial uNK cell counts do not predict successful implantation in an IVF population. Hum Reprod. 2019 Dec 1;34(12):2456-2466. doi: — View Citation

Groenewoud ER, Cantineau AE, Kollen BJ, Macklon NS, Cohlen BJ. What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis. Hum Reprod Update. 2013 Sep-Oct;19(5):458-70. doi: 10.109 — View Citation

Jing S, Li XF, Zhang S, Gong F, Lu G, Lin G. Increased pregnancy complications following frozen-thawed embryo transfer during an artificial cycle. J Assist Reprod Genet. 2019 May;36(5):925-933. doi: 10.1007/s10815-019-01420-1. Epub 2019 Mar 29. — View Citation

Liu X, Shi W, Shi J. Natural cycle frozen-thawed embryo transfer in young women with regular menstrual cycles increases the live-birth rates compared with hormone replacement treatment: a retrospective cohort study. Fertil Steril. 2020 Apr;113(4):811-817. — View Citation

Mackens S, Santos-Ribeiro S, van de Vijver A, Racca A, Van Landuyt L, Tournaye H, Blockeel C. Frozen embryo transfer: a review on the optimal endometrial preparation and timing. Hum Reprod. 2017 Nov 1;32(11):2234-2242. doi: 10.1093/humrep/dex285. Review. — View Citation

Melnick AP, Setton R, Stone LD, Pereira N, Xu K, Rosenwaks Z, Spandorfer SD. Replacing single frozen-thawed euploid embryos in a natural cycle in ovulatory women may increase live birth rates compared to medicated cycles in anovulatory women. J Assist Rep — View Citation

Merviel P, Challier JC, Carbillon L, Foidart JM, Uzan S. The role of integrins in human embryo implantation. Fetal Diagn Ther. 2001 Nov-Dec;16(6):364-71. Review. — View Citation

Neves AR, Devesa M, Martínez F, Garcia-Martinez S, Rodriguez I, Polyzos NP, Coroleu B. What is the clinical impact of the endometrial receptivity array in PGT-A and oocyte donation cycles? J Assist Reprod Genet. 2019 Sep;36(9):1901-1908. doi: 10.1007/s108 — View Citation

Rienzi L, Gracia C, Maggiulli R, LaBarbera AR, Kaser DJ, Ubaldi FM, Vanderpoel S, Racowsky C. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for t — View Citation

Riestenberg C, Kroener L, Quinn M, Ching K, Ambartsumyan G. Routine endometrial receptivity array in first embryo transfer cycles does not improve live birth rate. Fertil Steril. 2021 Apr;115(4):1001-1006. doi: 10.1016/j.fertnstert.2020.09.140. Epub 2021 — View Citation

Roque M, Haahr T, Geber S, Esteves SC, Humaidan P. Fresh versus elective frozen embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes. Hum Reprod Update. 2019 Jan 1;25(1):2-14. doi: 10.1093/humupd/dmy033. — View Citation

Shaodi Z, Qiuyuan L, Yisha Y, Cuilian Z. The effect of endometrial thickness on pregnancy outcomes of frozen-thawed embryo transfer cycles which underwent hormone replacement therapy. PLoS One. 2020 Sep 24;15(9):e0239120. doi: 10.1371/journal.pone.0239120 — View Citation

Simón C, Gómez C, Cabanillas S, Vladimirov I, Castillón G, Giles J, Boynukalin K, Findikli N, Bahçeci M, Ortega I, Vidal C, Funabiki M, Izquierdo A, López L, Portela S, Frantz N, Kulmann M, Taguchi S, Labarta E, Colucci F, Mackens S, Santamaría X, Muñoz E — View Citation

Teh WT, McBain J, Rogers P. What is the contribution of embryo-endometrial asynchrony to implantation failure? J Assist Reprod Genet. 2016 Nov;33(11):1419-1430. Epub 2016 Aug 1. Review. — View Citation

Wang A, Murugappan G, Kort J, Westphal L. Hormone replacement versus natural frozen embryo transfer for euploid embryos. Arch Gynecol Obstet. 2019 Oct;300(4):1053-1060. doi: 10.1007/s00404-019-05251-4. Epub 2019 Jul 23. — View Citation

Wang W, Sung N, Gilman-Sachs A, Kwak-Kim J. T Helper (Th) Cell Profiles in Pregnancy and Recurrent Pregnancy Losses: Th1/Th2/Th9/Th17/Th22/Tfh Cells. Front Immunol. 2020 Aug 18;11:2025. doi: 10.3389/fimmu.2020.02025. eCollection 2020. Review. — View Citation

Zaat T, Zagers M, Mol F, Goddijn M, van Wely M, Mastenbroek S. Fresh versus frozen embryo transfers in assisted reproduction. Cochrane Database Syst Rev. 2021 Feb 4;2:CD011184. doi: 10.1002/14651858.CD011184.pub3. — View Citation

Zanatta A, Rocha AM, Carvalho FM, Pereira RM, Taylor HS, Motta EL, Baracat EC, Serafini PC. The role of the Hoxa10/HOXA10 gene in the etiology of endometriosis and its related infertility: a review. J Assist Reprod Genet. 2010 Dec;27(12):701-10. doi: 10.1 — View Citation

* Note: There are 22 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Expression of endometrium	miRNA	through study completion, an average of 1.5 year
Secondary	Implantation factors of endometrium	HOXA10	through study completion, an average of 1.5 year
Secondary	Immune cells of endometrium	Uterine NK cells	through study completion, an average of 1.5 year