The Clinical Outcome of Ultra-low Oxygen Tension on Post Thawed Human Blastocyst

NCT ID: NCT03817671

Last Updated: 2019-01-28

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

Clinical Phase

NA

Total Enrollment

168 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-20

Study Completion Date

2020-06-30

Brief Summary

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The clinical outcome of Ultra-low oxygen tension on post thawed human blastocyst

Detailed Description

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In vitro, Embryo development depends on several factors as temperature, pH, and oxygen in the surrounding environment of the embryo. Impaired culture conditions are highly correlated with poor embryo development. Oxygen is a powerful regulator of embryo function , as it is responsible for cell respiration, energy production and rapid cell growth . Increased levels of oxygen is associated with an increase in the levels of ROS , which leads to unfavorable culture conditions, as it might affect the stability of cell membrane, DNA, and protein function .

In the female reproductive tract, oxygen concentration fluctuates between 2-8%, which is considered to be at its highest level in the fallopian tube, while the lowest level is in the uterus . Pre-implantation embryo crosses the uterotubal junction after the time of compaction on Day 3, where it is exposed to a shift in oxygen tension to 2%. This variation may have a role in the metabolic reactions of the embryo, and in its preparation for implantation process.

Some studies suggested that culturing embryos with oxygen tension below 5% may have an embryological advantage mimicking nature.

Embryological laboratories routinely use low Oxygen tension (5%). Our purpose is to investigate if ultra-low oxygen tension (2%) has an advantage over low oxygen tension (5%) for post thawed human embryo regarding clinical outcomes.

Conditions

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Embryo Development

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Control arm (5% O2)

After thawing, embryos will be cultured in 25 μl drop of pre-equilibrated dishes of media covered with a layer of oil for 1.5 hours at 5.7% CO2, 5% O2, and 89.3% N2 till embryo transfer

Group Type OTHER

5% O2

Intervention Type OTHER

Culturing embryos in 5% O2 just after thawing and till embryo transfer

Experimental arm (2%O2)

After thawing, embryos will be cultured in 25 μl drop of pre-equilibrated dishes of media covered with a layer of oil for 1.5 hours at 5.7% CO2, 2% O2, and 92.3% N2 till embryo transfer

Group Type EXPERIMENTAL

2% O2

Intervention Type OTHER

Culturing embryos in 2% O2 just after thawing and till embryo transfer

Interventions

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5% O2

Culturing embryos in 5% O2 just after thawing and till embryo transfer

Intervention Type OTHER

2% O2

Culturing embryos in 2% O2 just after thawing and till embryo transfer

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Single or Multiple Embryo transfer embryo transfer. Female age 18-40. Embryo vitrified on day 5 or day 6 of insemination.

Exclusion Criteria

Use of sperm donation. Use of Oocyte donation. Use of gestational carrier. Uterine congenital anomalies. Presence of any of the endometrial factors that affect embryo implantation such as hydrosalpings, adenomyosis or previously known uterine infection.

Any contradictions to undergoing in vitro fertilization or gonadotropin stimulation.
Minimum Eligible Age

5 Days

Maximum Eligible Age

6 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ganin Fertility Center

OTHER

Sponsor Role lead

Responsible Party

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Salma El Tanbouly

Senior Clinical Embryologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hosam Zaki, MSc, FRCOG

Role: STUDY_CHAIR

Ganin Fertility Center, Cairo, Egypt.

Salma El Tanbouly, BSc.

Role: PRINCIPAL_INVESTIGATOR

Ganin Fertility Center, Cairo, Egypt.

Abd El Ghafar Hussin, BSc.

Role: PRINCIPAL_INVESTIGATOR

Ganin Fertility Center, Cairo, Egypt.

Hanaa El Khedr

Role: PRINCIPAL_INVESTIGATOR

Ganin Fertility Center, Cairo, Egypt.

Locations

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Ganin Fertility Center

Cairo, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Hosam Zaki, MSc, FRCOG

Role: CONTACT

00201222150018

Salma El Tanbouly, BSc.

Role: CONTACT

00201279655807

Facility Contacts

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Hosam Zaki, MSc, FRCOG

Role: primary

00201222150018

Salma El Tanbouly, BSc

Role: backup

00201279655807

References

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Swain JE, Carrell D, Cobo A, Meseguer M, Rubio C, Smith GD. Optimizing the culture environment and embryo manipulation to help maintain embryo developmental potential. Fertil Steril. 2016 Mar;105(3):571-587. doi: 10.1016/j.fertnstert.2016.01.035. Epub 2016 Feb 3.

Reference Type BACKGROUND
PMID: 26851765 (View on PubMed)

Gardner DK. The impact of physiological oxygen during culture, and vitrification for cryopreservation, on the outcome of extended culture in human IVF. Reprod Biomed Online. 2016 Feb;32(2):137-41. doi: 10.1016/j.rbmo.2015.11.008. Epub 2015 Nov 25.

Reference Type BACKGROUND
PMID: 26687905 (View on PubMed)

Morin SJ. Oxygen tension in embryo culture: does a shift to 2% O2 in extended culture represent the most physiologic system? J Assist Reprod Genet. 2017 Mar;34(3):309-314. doi: 10.1007/s10815-017-0880-z. Epub 2017 Feb 8.

Reference Type BACKGROUND
PMID: 28181051 (View on PubMed)

Oliveira JB. Does embryo culture at low oxygen tension improve ART outcomes? JBRA Assist Reprod. 2017 Feb 1;21(1):1. doi: 10.5935/1518-0557.20170001. No abstract available.

Reference Type BACKGROUND
PMID: 28333022 (View on PubMed)

Kaser DJ, Bogale B, Sarda V, Farland LV, Williams PL, Racowsky C. Randomized controlled trial of low (5%) versus ultralow (2%) oxygen for extended culture using bipronucleate and tripronucleate human preimplantation embryos. Fertil Steril. 2018 Jun;109(6):1030-1037.e2. doi: 10.1016/j.fertnstert.2018.02.119.

Reference Type BACKGROUND
PMID: 29935641 (View on PubMed)

Ng KYB, Mingels R, Morgan H, Macklon N, Cheong Y. In vivo oxygen, temperature and pH dynamics in the female reproductive tract and their importance in human conception: a systematic review. Hum Reprod Update. 2018 Jan 1;24(1):15-34. doi: 10.1093/humupd/dmx028.

Reference Type BACKGROUND
PMID: 29077897 (View on PubMed)

Yang Y, Xu Y, Ding C, Khoudja RY, Lin M, Awonuga AO, Dai J, Puscheck EE, Rappolee DA, Zhou C. Comparison of 2, 5, and 20 % O2 on the development of post-thaw human embryos. J Assist Reprod Genet. 2016 Jul;33(7):919-27. doi: 10.1007/s10815-016-0693-5. Epub 2016 Mar 23.

Reference Type BACKGROUND
PMID: 27007876 (View on PubMed)

Leese HJ. Human embryo culture: back to nature. J Assist Reprod Genet. 1998 Sep;15(8):466-8. doi: 10.1023/a:1022526219202. No abstract available.

Reference Type BACKGROUND
PMID: 9785193 (View on PubMed)

Other Identifiers

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GFCST11991

Identifier Type: -

Identifier Source: org_study_id

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