Investigation of Embryoscopy in Recurrent Pregnancy Loss

NCT ID: NCT00589446

Last Updated: 2009-06-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-01-31

Study Completion Date

2009-01-31

Brief Summary

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The purpose is to test the value of embryoscopy in women with missed abortions after recurrent miscarriages (at least two previous miscarriages) in the past. This project will assess two functions of embryoscopy:-

1. Whether embryoscopy allows the diagnosis of structural anomalies (disorganized embryos). This is a fetal cause of embryo loss which cannot be diagnosed by other means.
2. Whether embryoscopy allows an accurate biopsy of embryonic tissue for karyotyping.

However, it may be that embryoscopy will be found to have no advantage.

Detailed Description

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In this project, embryoscopy will be evaluated in women with missed abortions (pregnancies which have ceased developing and in which the embryo is dead), after at least two previous (recurrent) miscarriages. The procedure will have two main purposes:- To allow the diagnosis of structural anomalies (disorganized embryos), and to allow an accurate biopsy of embryonic tissue for karyotyping. Hence, this procedure will lead to a more accurate diagnosis of the cause of recurrent miscarriage.

After confirmation of missed abortion by ultrasound, dilatation and curettage (D\&C) is normally performed under general anesthetic to evacuate the uterus in missed abortions. In this project embryoscopy will be added to the standard D\&C. An 8mm hysteroscope with irrigation channel and 300 view will be used with continuous saline flow. The embryo will be visualized, and the findings recorded. Biopsies will be taken for chromosomal analysis from the embryo and the placental villi. Embryoscopy will be performed with a hysteroscope which is in normal clinical use for investigating the uterine cavity, but for a slightly different indication.

The first stage will be a pilot study on 20 patients to judge the value of embryoscopy.

Conditions

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Recurrent Miscarriage

Keywords

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Embryoscopy recurrent miscarriage missed abortion Structural anomalies in recurrent miscarriage Embryoscopically directed biopsy for karyotyping

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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1

Embryoscopy will be evaluated in women with at least two previous miscarriages, after confirmation of missed abortion by ultrasound. Embryoscopy will only be performed in patients in whom curettage is clinically indicated, and will only be added to the D\&C if there is a possibility of visualizing embryonic tissue, i:e. from approximately 5½ weeks onwards when there is an embryonic pole detected on ultrasound.

Group Type EXPERIMENTAL

Hysteroscope

Intervention Type DEVICE

An 8mm hysteroscope with irrigation channel and 30 degree view will be inserted into the uterus prior to curettage in cases of recurrent missed abortion

Interventions

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Hysteroscope

An 8mm hysteroscope with irrigation channel and 30 degree view will be inserted into the uterus prior to curettage in cases of recurrent missed abortion

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Recurrent miscarriage, (at least 2 consecutive miscarriages)
* Confirmation of missed abortion by ultrasound
* At least 5 1/2 weeks of gestation
* D \& C is clinically indicated

Exclusion Criteria

* Sporadic miscarriages
* Less than two consecutive miscarriages.
* If D \& C is not clinically indicated
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Herzliya Medical Center

OTHER

Sponsor Role collaborator

Sheba Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Sheba Medical Center

Principal Investigators

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Howard JA Carp, MB BS. FRCOG

Role: PRINCIPAL_INVESTIGATOR

Sheba Medical Center

Locations

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Herzlia Medical Center

Herzliya, , Israel

Site Status

Sheba Medical Center

Tel Litwinsky, , Israel

Site Status

Countries

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Israel

References

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Philipp T, Philipp K, Reiner A, Beer F, Kalousek DK. Embryoscopic and cytogenetic analysis of 233 missed abortions: factors involved in the pathogenesis of developmental defects of early failed pregnancies. Hum Reprod. 2003 Aug;18(8):1724-32. doi: 10.1093/humrep/deg309.

Reference Type BACKGROUND
PMID: 12871891 (View on PubMed)

Ferro J, Martinez MC, Lara C, Pellicer A, Remohi J, Serra V. Improved accuracy of hysteroembryoscopic biopsies for karyotyping early missed abortions. Fertil Steril. 2003 Nov;80(5):1260-4. doi: 10.1016/s0015-0282(03)02195-2.

Reference Type RESULT
PMID: 14607585 (View on PubMed)

Philipp T, Kalousek DK. Transcervical embryoscopy in missed abortion. J Assist Reprod Genet. 2001 May;18(5):285-90. doi: 10.1023/a:1016666301481.

Reference Type RESULT
PMID: 11464580 (View on PubMed)

Other Identifiers

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SHEBA-05-3804-HC-CTIL

Identifier Type: -

Identifier Source: org_study_id