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CompletedNCT04571671AMUpdated Oct 5, 2020

Do müllerian Anomalies Affect Embryo Implantation?

An observational study in Uterine Diseases, sponsored by IVI Vigo. Completed. Open to female participants aged 35 Years to 50 Years. Per ClinicalTrials.gov, last updated 2020-10-05.

Sponsored by IVI Vigo · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
5,000
Ages
35 Years to 50 Years
Sex
Female
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Study summary

Müllerian anomalies (MA) are associated with infertility and affect approximately 6.3% of the infertile population. The estimation of the frequency of MAs is not without controversy because it depends on the diagnostic method used and sometimes on the established diagnostic criteria. This pathology is associated with abortion during the second trimester in addition to other complications that include preterm labor, fetal malpositions and an increased rate of caesarean section, although some patients may remain asymptomatic. An association between MA and endometriosis has been described and in particular the case of the septum uterus, therefore it is difficult to establish whether the reproductive results of women with MA tdepend only on the uterine factor or also on the quality of the oocytes.

Read the detailed description

The main reproductive problems associated with these malformations include, abortion , recurrent abortion ectopic pregnancy and preterm delivery . The experience gained from oocyte donation shows that these women are pregnant less, even with the transfer of good quality embryos. The hypothesis of this poor uterine receptivity is in the poor endometrial vascularization that can decrease embryo implantation. The reason for infertility in women with AM includes decreased muscle mass, decreased endometrial vascularization, decreased capacity of the endometrial cavity, less receptive areas (septum). The lower fertility observed in some women with Müllerian malformations has been partially explained by its tubal factor and its association with endometriosis, with a higher prevalence in them, compared to patients without malformations.

Studies have confirmed an irregular differentiation and estrogenic maturation of the endometrium lining the uterine septum or its internal structure, which has less presence of connective tissue and more muscle mass. Given the confusion generated if the unfavorable reproductive result is due to oocyte quality or endometrial receptivity, it is necessary to use a model that guarantees oocyte / embryo quality and this is offered by oocyte donation. The aim is to evaluate the implantation rate in women with MA who receive donated oocytes compared to women without MA.

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Conditions studied

  • Uterine Diseases

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03

Who can participate

Ages eligible
35 Years to 50 Years
Sexes eligible
Female
Sampling method
Non-probability sample

Study population

Women with Müllerian anomalies who have received an oocyte donation. The diagnosis of Müllerian anomalies is established when a cavity is demonstrated uterine abnormality with any of the defects described in the American classifications or European in transvaginal ultrasound, hysteroscopy or hysterosalpingography (HSG). The differential diagnosis in case of doubts is established with 3D ultrasound, MRI or hystero / laparoscopy. All the septa have been resected prior to performing the OVODON cycle.

Inclusion criteria

  • Women included in the oocyte donation program at IVI Vigo and Valencia 2000-2019.
  • Sperm count greater than 1,000,000 per ml.
  • Transfer on day 5 of embryo development of at least one good quality embryo.

Exclusion criteria

Exclusion Criteria:

  • Testicular biopsy.
  • Any indication for preimplantation genetic diagnosis or screening.
  • Uterine fibroid greater than 4 cm.
  • Presence of ultrasound or diagnosis by HSG or laparoscopy of hydrosalpinx uni or bilateral.
  • Recurrent abortion.
  • Any abnormality of the uterine cavity other than MA: submucosal myoma, endometrial polyp, or uterine synechiae.
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Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
5,000 participants (actual)
Patient registry
No

Groups and cohorts

  • Study group

    Women with Müllerian anomalies who have received an oocyte donation. The diagnosis of Müllerian anomalies is established when a cavity is demonstrated uterine abnormality with any of the defects described in the American classifications or European in transvaginal ultrasound, hysteroscopy or hysterosalpingography (HSG). The differential diagnosis in case of doubts is established with 3D ultrasound, MRI or hystero / laparoscopy. All the septa have been resected prior to performing the OVODON cycle.

    Other: Collect retrospectively data

  • Control group

    Patients who receive donated oocytes and who do not present Müllerian anomalies. An absence of AM, a transvaginal ultrasound, an HSG or a normal hysteroscopy with a uterine cavity with a normal shape and absence of intracavitary images is considered

    Other: Collect retrospectively data

Interventions

  • OtherCollect retrospectively data

    Analyse the incidence of Mullerian anomalies in these populations

05

What researchers measure

Primary outcomes

  1. embryo implantation rate

    To compare embryo implantation rate

    Time frame: Since 2000 to april 2019

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Study locations

No study locations are listed for this record.

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References and documents

Publications

  • Makino T, Umeuchi M, Nakada K, Nozawa S, Iizuka R. Incidence of congenital uterine anomalies in repeated reproductive wastage and prognosis for pregnancy after metroplasty. Int J Fertil. 1992 May-Jun;37(3):167-70. PubMed 1355763 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT04571671
Lead sponsor
IVI Vigo
Collaborators
Instituto Valenciano de Infertilidad, IVI VALENCIA
Responsible party
Sponsor
First posted
Oct 1, 2020
Start date
Jan 20, 2014
Primary completion
Jul 25, 2019
Completion
Jul 25, 2019
Last update
Oct 5, 2020

Study contacts

Ekin DR Muñoz, MD
principal investigator · IVI Vigo
Agustina Ramos Gutierrez
study chair · IVI Vigo

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2020. You cannot join it, but the record below documents what was studied.

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