Preimplantation Genetic Diagnosis Using Blastocyst Biopsy and Array CGH

NCT ID: NCT01546350

Last Updated: 2013-08-21

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

SUSPENDED

Clinical Phase

PHASE2

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-03-31

Study Completion Date

2014-06-30

Brief Summary

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The investigators propose to perform a clinical randomized trial to evaluate the effect of single embryo (blastocyst) transfer (SET) with array CGH for the evaluation of the complete chromosome complement of the blastocyst in comparison to standard ART methods in which one or more embryo are replaced. Patients will be randomized into two groups:

* Control group: patients will have up to two embryos replaced on day 5 based on morphological and developmental characteristics, and the other embryos reaching blastocyst stage will be vitrified. If patients in the control group do not have a pregnancy to term from that fresh cycle, they will be offered free PGD either for the frozen embryos of that cycle or for the next cycle (up to the center and patient). Data from that PGD is not part of the study.
* Test group: patients will have grade A,B or C blastocysts hatched on day 5, biopsied on day 5, analyzed by array CGH, and a single euploid embryo transferred on day 6. Any morulas developing to grade A,B or C blastocyst on day-6 will be also analyzed but vitrified for use in a future cycle.

Detailed Description

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Patients will be randomized after fertilization, and will be dropped from the study if they produce 3 or less blastocysts on day 5. The Primary efficacy endpoint of comparing the study group with the control will be (I) implantation rates and (II) multiple pregnancies (twin or higher order) comparing the first transfer.

The study may be extended to evaluate secondary efficacy endpoints which will be miscarriage rate and take home baby rates comparing the two groups.

Conditions

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Infertility Recurrent Pregnancy Loss

Keywords

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infertility, recurrent pregnancy loss, miscarriage

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Control - regular ART treatment

patients will have up to two embryos replaced on day 5 based on morphological and developmental characteristics, and the other embryos reaching blastocyst stage will be vitrified. If patients in the control group do not have a pregnancy to term from that fresh cycle, they will be offered free PGD either for the frozen embryos of that cycle or for the next cycle (up to the center and patient). Data from that PGD is not part of the study.

Group Type NO_INTERVENTION

No interventions assigned to this group

Test - PGD

patients will have grade A,B or C blastocysts hatched on day 5, biopsied on day 5, analyzed by array CGH, and a single euploid embryo transferred on day 6. Any morulas developing to grade A,B or C blastocyst on day-6 will be also analyzed but vitrified for use in a future cycle.

Group Type EXPERIMENTAL

PGD

Intervention Type GENETIC

array CGH after blastocyst biopsy

PGD

Intervention Type PROCEDURE

PGD using blastocyst biopsy and testing of the biopsy by array CGH

Interventions

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PGD

array CGH after blastocyst biopsy

Intervention Type GENETIC

PGD

PGD using blastocyst biopsy and testing of the biopsy by array CGH

Intervention Type PROCEDURE

Other Intervention Names

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PGD: Preimplantation Genetic Diagnosis

Eligibility Criteria

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Inclusion Criteria

* Maternal age 33 to 42 years old (included)

Exclusion Criteria

* MESA and TESE patients
* At least one partner carrier of a chromosomal or genetic disease
* Abnormal ovarian reserve, defined as FSH of \>10 IU/L on day 2-4 of the cycle and AMH \< 1ng /ml (If only one of the two parameters altered then patients is acceptable).
* Egg donor cycle (sperm donor is acceptable)


* Less than eight antral follicles on day 2-4 of cycle


* Patients will be excluded if they produce less than 3 grade A,B or C blastocysts by day 5.
Minimum Eligible Age

32 Years

Maximum Eligible Age

42 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Reprogenetics, Livingston, NJ

UNKNOWN

Sponsor Role collaborator

Long Island IVF, Melville, NY

UNKNOWN

Sponsor Role collaborator

Reproductive Associates of Illinois, Highland Park, IL

UNKNOWN

Sponsor Role collaborator

Yale University

OTHER

Sponsor Role collaborator

McGill University

OTHER

Sponsor Role collaborator

BlueGnome, Cambridge, UK

UNKNOWN

Sponsor Role collaborator

Southern California Reproductive Center, CA

UNKNOWN

Sponsor Role collaborator

Reprogenetics

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Santiago Munne, PhD

Role: STUDY_DIRECTOR

Reprogenetics

Locations

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Southern California Reproductive Center

Beverly Hills, California, United States

Site Status

Reproductive Associates of Illinois

Highland Park, Illinois, United States

Site Status

Reprogenetics

Livingston, New Jersey, United States

Site Status

Long Island IVF

Melville, New York, United States

Site Status

Countries

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United States

References

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Gutierrez-Mateo C, Colls P, Sanchez-Garcia J, Escudero T, Prates R, Ketterson K, Wells D, Munne S. Validation of microarray comparative genomic hybridization for comprehensive chromosome analysis of embryos. Fertil Steril. 2011 Mar 1;95(3):953-8. doi: 10.1016/j.fertnstert.2010.09.010. Epub 2010 Oct 25.

Reference Type BACKGROUND
PMID: 20971462 (View on PubMed)

Cohen J, Wells D, Munne S. Removal of 2 cells from cleavage stage embryos is likely to reduce the efficacy of chromosomal tests that are used to enhance implantation rates. Fertil Steril. 2007 Mar;87(3):496-503. doi: 10.1016/j.fertnstert.2006.07.1516. Epub 2006 Dec 4.

Reference Type BACKGROUND
PMID: 17141767 (View on PubMed)

Munne S, Wells D, Cohen J. Technology requirements for preimplantation genetic diagnosis to improve assisted reproduction outcomes. Fertil Steril. 2010 Jul;94(2):408-30. doi: 10.1016/j.fertnstert.2009.02.091. Epub 2009 May 5.

Reference Type BACKGROUND
PMID: 19409550 (View on PubMed)

Schoolcraft WB, Fragouli E, Stevens J, Munne S, Katz-Jaffe MG, Wells D. Clinical application of comprehensive chromosomal screening at the blastocyst stage. Fertil Steril. 2010 Oct;94(5):1700-6. doi: 10.1016/j.fertnstert.2009.10.015. Epub 2009 Nov 25.

Reference Type BACKGROUND
PMID: 19939370 (View on PubMed)

De Vos A, Staessen C, De Rycke M, Verpoest W, Haentjens P, Devroey P, Liebaers I, Van de Velde H. Impact of cleavage-stage embryo biopsy in view of PGD on human blastocyst implantation: a prospective cohort of single embryo transfers. Hum Reprod. 2009 Dec;24(12):2988-96. doi: 10.1093/humrep/dep251. Epub 2009 Sep 21.

Reference Type BACKGROUND
PMID: 19773223 (View on PubMed)

Other Identifiers

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Reprogenetics study 389

Identifier Type: OTHER

Identifier Source: secondary_id

Reprogenetics study 389

Identifier Type: -

Identifier Source: org_study_id