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TerminatedNCT01322971Updated Dec 20, 2021Results posted

Efficacy Study of Preconception Treatment of an Asymptomatic Bacterial Infection in an Infertility Population

An interventional study of Metronidazole and Placebo in Vaginosis, Bacterial, Infertility and Miscarriage, sponsored by Stanford University. Terminated at 1 site in United States. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-12-20.

Sponsored by Stanford University · Not applicable, Interventional, and Treatment

Why this study was terminated
Disease prevalence lower than expected in population.
Phase
Not applicable
Study type
Interventional
Enrollment
2
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

Bacterial vaginosis (BV) is a common vaginal infection characterized by a pathologic shift in the normal vaginal flora. BV has been associated with a number of poor reproductive outcomes, including infertility, preterm labor and premature rupture of membranes. If BV does disrupt normal embryologic development, then the treatment of BV prior to conception may improve implantation rates and other pregnancy outcomes in the infertile population.

This is a prospective, randomized, double-blind, placebo-controlled trial in which infertile women undergoing intrauterine insemination or embryo transfer are screened for BV prior to treatment. Those patients who screen positive for BV will then be randomized into the treatment arm(metronidazole 500mg by mouth twice daily for 7 days) or the control arm (placebo by mouth twice daily for 7 days). The primary outcome, positive pregnancy test rate (i.e. biochemical pregnancy rate), will then be assessed. Secondary outcomes, such as clinical pregnancy rate, miscarriage rate, and live birth rate will also be examined.

Read the detailed description

The purpose of this study is to determine if preconception treatment of asymptomatic bacterial vaginosis improves pregnancy outcomes (i.e. biochemical pregnancy rate). Study protocol as follows:

  1. Patients will be notified of study via face-to-face contact at the initial clinic visit (baseline ultrasound visit, menstrual cycle day 2-5), by physician referral or the Stanford website. Patients expressing interest will be screened in person to confirm that they meet all enrollment criteria. The participant will be asked to sign informed consent documents and a brief intake questionnaire with then be administered.
  2. Enrolled patients will then be screened for bacterial vaginosis at their next visit (typically on menstrual cycle day 12), prior to transvaginal ultrasound. The screening will require that a speculum be inserted into the vagina and a vaginal smear be collected with a swab from the posterior fornix. A microscopic slide will be prepared by rolling the swab on the surface of a glass slide. The diagnosis of bacterial vaginosis will be established clinically using the Amsel criteria to confirm 3 of the following 4 signs: clue cells; vaginal pH ≥4.5; fishy odor before or after the addition of 10% potassium hydroxide solution to a wet-mount side; and a homogeneous, off-white, discharge. For validation of clinical diagnosis, 100% of screen positive slides, and 10% of screen negative slides, will be sent for to the Department of Pathology for Gram staining.
  3. The patients with a positive screen for bacterial vaginosis will then be randomized to receive metronidazole 500mg orally twice daily for seven days (treatment arm) or placebo orally twice daily for seven days(control arm). Randomization will be performed using a computer-generated code. Those patients whose screen is negative will also be followed for outcomes, but no randomization will be performed.
  4. All randomized patients will continue with routine monitoring and insemination as planned by their treating physician.
  5. If pregnancy is confirmed at least 12 weeks after intrauterine insemination by ultrasound evidence of a fetus with heartbeat, information will then be collected regarding the pregnancy and its outcome.
  6. Primary and secondary outcomes will be followed for 2 years after date of enrollment for all patients.
02

Conditions studied

  • Vaginosis, Bacterial
  • Infertility
  • Miscarriage

Keywords

  • Bacterial Vaginosis
  • Infertility
  • Miscarriage
  • Metronidazole
03

In context

Vaginosis, Bacterial

220 studies on the registry are indexed under Vaginosis, Bacterial; 36 are open to participants now.

This study's enrollment of 2 is below the median of 100 across 187 interventional studies indexed under Vaginosis, Bacterial.

Browse Vaginosis, Bacterial studies →

Lead sponsor

Stanford University is the lead sponsor of 2,117 studies on the registry; 425 are open to participants now.

Of its 259 completed or terminated interventional studies of FDA-regulated products, 197 (76%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • Women who are actively trying to conceive via intrauterine insemination or in vitro fertilization

Exclusion criteria

Exclusion Criteria:

  • Current use of an oral or vaginal antibiotic.
  • History of allergy or adverse reaction to metronidazole.
  • Prior enrollment in study (patients returning for repeat cycle may not be re-enrolled).
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
2 participants (actual)

Study arms

  • Active comparator
    Metronidazole

    Patients randomized to the metronidazole arm will receive metronidazole 500mg orally twice daily for seven days.

    Drug: Metronidazole

  • Placebo comparator
    Placebo

    Patients randomized to the placebo arm will receive placebo orally twice daily for seven days(control arm

    Drug: Placebo

Interventions

  • DrugMetronidazole

    Metronidazole 500mg orally twice daily for seven days

  • DrugPlacebo

    Placebo will be administered orally twice daily for seven days

06

What researchers measure

Primary outcomes

  1. Biochemical Pregnancy Rate (Positive Pregnancy Test)

    Biochemical pregnancy rate was defined as number of participants who had a positive pregnancy test

    Time frame: up to 2 years

Secondary outcomes

  1. Pregnancy Rate (Pregnancy Visible on Ultrasound)

    Time frame: up to 2 years

  2. Miscarriage Rate (Loss of a Clinically Recognized Pregnancy)

    Time frame: up to 2 years

  3. Infectious Morbidity (i.e. Chorioamnionitis, Neonatal Sepsis)

    Time frame: up to 2 years

07

Results

Posted Jan 20, 2017
Limitations and caveats
151 screened 2 were randomized both refused to take medication not knowing if it were placebo or drug

Participant flow

Participant flow — Overall Study
MilestoneMetronidazolePlacebo
Started11
Completed00
Not completed11

Outcome measures

PrimaryBiochemical Pregnancy Rate (Positive Pregnancy Test)

Biochemical pregnancy rate was defined as number of participants who had a positive pregnancy test

Time frame:
up to 2 years

No measurements were reported for this outcome.

SecondaryPregnancy Rate (Pregnancy Visible on Ultrasound)
Time frame:
up to 2 years

No measurements were reported for this outcome.

SecondaryMiscarriage Rate (Loss of a Clinically Recognized Pregnancy)
Time frame:
up to 2 years

No measurements were reported for this outcome.

SecondaryInfectious Morbidity (i.e. Chorioamnionitis, Neonatal Sepsis)
Time frame:
up to 2 years

No measurements were reported for this outcome.

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Metronidazole———
Placebo———

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)MetronidazolePlaceboTotal
<=18 years000
Between 18 and 65 years112
>=65 years000
Age, Continuous
Age, Continuous(years)MetronidazolePlaceboTotal
Median37 ± 037 ± 037 ± 0
Sex: Female, Male
Sex: Female, Male(Participants)MetronidazolePlaceboTotal
Female112
Male000
Region of Enrollment
Region of Enrollment(participants)MetronidazolePlaceboTotal
United States112
08

Study locations

1 site
  • Ruth Lathi
    Stanford, California 94305, United States
09

References and documents

Publications

  • American College of Obstetricians and Gynecologists. ACOG Practice Bulletin. Assessment of risk factors for preterm birth. Clinical management guidelines for obstetrician-gynecologists. Number 31, October 2001. (Replaces Technical Bulletin number 206, June 1995; Committee Opinion number 172, May 1996; Committee Opinion number 187, September 1997; Committee Opinion number 198, February 1998; and Committee Opinion number 251, January 2001). Obstet Gynecol. 2001 Oct;98(4):709-16. PubMed 11592272 ↗
  • Carey JC, Klebanoff MA, Hauth JC, Hillier SL, Thom EA, Ernest JM, Heine RP, Nugent RP, Fischer ML, Leveno KJ, Wapner R, Varner M. Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. N Engl J Med. 2000 Feb 24;342(8):534-40. doi: 10.1056/NEJM200002243420802. PubMed 10684911 ↗
  • Donders GG, Van Bulck B, Caudron J, Londers L, Vereecken A, Spitz B. Relationship of bacterial vaginosis and mycoplasmas to the risk of spontaneous abortion. Am J Obstet Gynecol. 2000 Aug;183(2):431-7. doi: 10.1067/mob.2000.105738. PubMed 10942482 ↗
  • Hay PE, Lamont RF, Taylor-Robinson D, Morgan DJ, Ison C, Pearson J. Abnormal bacterial colonisation of the genital tract and subsequent preterm delivery and late miscarriage. BMJ. 1994 Jan 29;308(6924):295-8. doi: 10.1136/bmj.308.6924.295. PubMed 8124116 ↗
  • Hay PE. Bacterial vaginosis and miscarriage. Curr Opin Infect Dis. 2004 Feb;17(1):41-4. doi: 10.1097/00001432-200402000-00008. PubMed 15090889 ↗
  • Hillier SL, Nugent RP, Eschenbach DA, Krohn MA, Gibbs RS, Martin DH, Cotch MF, Edelman R, Pastorek JG 2nd, Rao AV, et al. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med. 1995 Dec 28;333(26):1737-42. doi: 10.1056/NEJM199512283332604. PubMed 7491137 ↗
  • Korn AP, Bolan G, Padian N, Ohm-Smith M, Schachter J, Landers DV. Plasma cell endometritis in women with symptomatic bacterial vaginosis. Obstet Gynecol. 1995 Mar;85(3):387-90. doi: 10.1016/0029-7844(94)00400-8. PubMed 7862377 ↗
  • Liversedge NH, Turner A, Horner PJ, Keay SD, Jenkins JM, Hull MG. The influence of bacterial vaginosis on in-vitro fertilization and embryo implantation during assisted reproduction treatment. Hum Reprod. 1999 Sep;14(9):2411-5. doi: 10.1093/humrep/14.9.2411. PubMed 10469722 ↗
  • McDonald HM, Brocklehurst P, Gordon A. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD000262. doi: 10.1002/14651858.CD000262.pub3. PubMed 17253447 ↗
  • Nelson DB, Bellamy S, Nachamkin I, Ness RB, Macones GA, Allen-Taylor L. First trimester bacterial vaginosis, individual microorganism levels, and risk of second trimester pregnancy loss among urban women. Fertil Steril. 2007 Nov;88(5):1396-403. doi: 10.1016/j.fertnstert.2007.01.035. Epub 2007 Apr 16. PubMed 17434499 ↗
  • Platz-Christensen JJ, Brandberg A, Wiqvist N. Increased prostaglandin concentrations in the cervical mucus of pregnant women with bacterial vaginosis. Prostaglandins. 1992 Feb;43(2):133-4. doi: 10.1016/0090-6980(92)90082-5. PubMed 1542740 ↗
  • Platz-Christensen JJ, Mattsby-Baltzer I, Thomsen P, Wiqvist N. Endotoxin and interleukin-1 alpha in the cervical mucus and vaginal fluid of pregnant women with bacterial vaginosis. Am J Obstet Gynecol. 1993 Nov;169(5):1161-6. doi: 10.1016/0002-9378(93)90274-m. PubMed 8238178 ↗
  • Wilson JD, Ralph SG, Rutherford AJ. Rates of bacterial vaginosis in women undergoing in vitro fertilisation for different types of infertility. BJOG. 2002 Jun;109(6):714-7. doi: 10.1111/j.1471-0528.2002.01297.x. PubMed 12118653 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 20, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01322971
Lead sponsor
Stanford University
Responsible party
Ruth Bunker Lathi (Principal Investigator, Stanford University) — Principal investigator
First posted
Mar 25, 2011
Start date
Feb 2011
Primary completion
Jun 2012
Completion
Jun 2012
Results posted
Jan 20, 2017
Last update
Dec 20, 2021

Study contacts

Ruth Bunker Lathi
principal investigator · Stanford University

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Dec 2021. You cannot join it, but the record below documents what was studied.

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