Pregnancy Rate in Women With Normal Uterine Cavity and Those With Corrected Uterine Lesions in ICSI Cycles

NCT ID: NCT03680690

Last Updated: 2018-09-24

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

UNKNOWN

Total Enrollment

244 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-10-01

Study Completion Date

2020-02-28

Brief Summary

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The aim of the current study is to investigate the pregnancy rate in women with normal uterine cavity and those detected or corrected uterine cavitary lesions, assessed by hysteroscopy in ICSI cycles.

Detailed Description

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Intrauterine pathology has been reported in up to 25% of infertile women having IVF treatment and in as many as 50% of women with recurrent implantation failure, leading to suggestions that correction of such pathology could improve treatment outcome. Hysteroscopy allows visual assessment of the cervical canal and uterine cavity and provides the opportunity to operate in the same setting. Routine outpatient hysteroscopy before starting IVF has been postulated to diagnose and treat abnormalities of the cervix and uterine cavity and hence improve IVF outcome.

A systematic review of published studies suggested that outpatient hysteroscopy in the menstrual cycle preceding an IVF treatment cycle could significantly increase the clinical pregnancy rate in women who had previously had recurrent implantation failure, even when no hysteroscopic abnormality was detected.

However, the result of the TROPHY study - published in the Lancet in 2016 concluded that Outpatient hysteroscopy before IVF in women with a normal ultrasound of the uterine cavity and a history of unsuccessful IVF treatment cycles does not improve the livebirth rate and they recommended that further research into the effectiveness of surgical correction of specific uterine cavity abnormalities before IVF is warranted.

An MD thesis done in our department on the evaluation of the endometrial cavity in infertile patients and prior to IVF recommended that there is an urgent need to RCT to emphasize the benefit of removal of the detected intrauterine lesions before proceeding to IVF.

Conditions

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Intracytoplasmic Sperm Injection

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Group A

women with normal uterus,detected by hysteroscopy.

hysteroscopy

Intervention Type PROCEDURE

office hysteroscopy will be done for all candidates and operative correction of detected lesions will be carried on.

Group B

Women with detected or corrected uterine cavitary lesions by hysteroscopy.

hysteroscopy

Intervention Type PROCEDURE

office hysteroscopy will be done for all candidates and operative correction of detected lesions will be carried on.

Interventions

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hysteroscopy

office hysteroscopy will be done for all candidates and operative correction of detected lesions will be carried on.

Intervention Type PROCEDURE

Other Intervention Names

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hysteroscopic uterine lesion detection or correction

Eligibility Criteria

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Inclusion Criteria

* Women between 18 and 38 years old.
* An indication for IVF/ICSI.
* Normal 2D transvaginal U/S assessment of the uterine cavity, or abnormal cavity detected by 2D ,3D and HSG.
* Women with primary or secondary infertility.
* Women with BMI between 20 \& 35.

Exclusion Criteria

* Refusal to join the study.
* Untreated tubal hydrosalpinges.
* Poor responders as assessed by AFC 4 or less ,AMH O.8 ng/dl (nice 2013).
Minimum Eligible Age

18 Years

Maximum Eligible Age

38 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Momen Ahmed Mohammed Kamel

Principle investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ahmed Youssef, MD/MSC

Role: STUDY_CHAIR

women's health hospital,Assiut university

Ibrahim Mohammed, MD/MSc

Role: STUDY_DIRECTOR

women's health hospital,Assiut university

Sayed Moustafa, MD/MSC

Role: PRINCIPAL_INVESTIGATOR

women's health hospital,Assiut university

Ahmed Kamel, MSC/MBBh

Role: PRINCIPAL_INVESTIGATOR

women's health hospital,Assiut university

Central Contacts

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Ahmed Kamel, MSc/Mbbh

Role: CONTACT

00201003627020

Ahmed Youssef, MD/Mssc/Mbbh

Role: CONTACT

01006184921

References

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Polanski LT, Baumgarten MN, Quenby S, Brosens J, Campbell BK, Raine-Fenning NJ. What exactly do we mean by 'recurrent implantation failure'? A systematic review and opinion. Reprod Biomed Online. 2014 Apr;28(4):409-23. doi: 10.1016/j.rbmo.2013.12.006. Epub 2014 Jan 17.

Reference Type RESULT
PMID: 24581986 (View on PubMed)

Coughlan C, Walters S, Ledger W, Li TC. A comparison of psychological stress among women with and without reproductive failure. Int J Gynaecol Obstet. 2014 Feb;124(2):143-7. doi: 10.1016/j.ijgo.2013.08.006. Epub 2013 Oct 31.

Reference Type RESULT
PMID: 24290538 (View on PubMed)

Zeyneloglu HB, Onalan G. Remedies for recurrent implantation failure. Semin Reprod Med. 2014 Jul;32(4):297-305. doi: 10.1055/s-0034-1375182. Epub 2014 Jun 11.

Reference Type RESULT
PMID: 24919029 (View on PubMed)

Papathanasiou A, Bhattacharya S. Prognostic factors for IVF success: diagnostic testing and evidence-based interventions. Semin Reprod Med. 2015 Mar;33(2):65-76. doi: 10.1055/s-0035-1545364. Epub 2015 Mar 3.

Reference Type RESULT
PMID: 25734344 (View on PubMed)

Moini A, Kiani K, Ghaffari F, Hosseini F. Hysteroscopic findings in patients with a history of two implantation failures following in vitro fertilization. Int J Fertil Steril. 2012 Apr;6(1):27-30. Epub 2012 Jun 19.

Reference Type RESULT
PMID: 25505508 (View on PubMed)

Cenksoy P, Ficicioglu C, Yildirim G, Yesiladali M. Hysteroscopic findings in women with recurrent IVF failures and the effect of correction of hysteroscopic findings on subsequent pregnancy rates. Arch Gynecol Obstet. 2013 Feb;287(2):357-60. doi: 10.1007/s00404-012-2627-5. Epub 2012 Nov 27.

Reference Type RESULT
PMID: 23183783 (View on PubMed)

Dicker D, Ashkenazi J, Feldberg D, Farhi J, Shalev J, Ben-Rafael Z. The value of repeat hysteroscopic evaluation in patients with failed in vitro fertilization transfer cycles. Fertil Steril. 1992 Oct;58(4):833-5. doi: 10.1016/s0015-0282(16)55338-2.

Reference Type RESULT
PMID: 1426335 (View on PubMed)

La Sala GB, Montanari R, Dessanti L, Cigarini C, Sartori F. The role of diagnostic hysteroscopy and endometrial biopsy in assisted reproductive technologies. Fertil Steril. 1998 Aug;70(2):378-80. doi: 10.1016/s0015-0282(98)00147-2.

Reference Type RESULT
PMID: 9696242 (View on PubMed)

Levi Setti PE, Colombo GV, Savasi V, Bulletti C, Albani E, Ferrazzi E. Implantation failure in assisted reproduction technology and a critical approach to treatment. Ann N Y Acad Sci. 2004 Dec;1034:184-99. doi: 10.1196/annals.1335.021.

Reference Type RESULT
PMID: 15731311 (View on PubMed)

El-Toukhy T, Campo R, Khalaf Y, Tabanelli C, Gianaroli L, Gordts SS, Gordts S, Mestdagh G, Mardesic T, Voboril J, Marchino GL, Benedetto C, Al-Shawaf T, Sabatini L, Seed PT, Gergolet M, Grimbizis G, Harb H, Coomarasamy A. Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet. 2016 Jun 25;387(10038):2614-2621. doi: 10.1016/S0140-6736(16)00258-0. Epub 2016 Apr 27.

Reference Type RESULT
PMID: 27132053 (View on PubMed)

Other Identifiers

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pregnancy rate in ICSI cycles

Identifier Type: -

Identifier Source: org_study_id

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