The Outcome and Influence Factors of Assisted Reproductive Therapy in Patients With Cesarean Scar Uterus.

NCT ID: NCT04070222

Last Updated: 2019-12-24

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

120 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-08-01

Study Completion Date

2023-04-30

Brief Summary

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Mode of delivery affects the success rate of assisted reproductive techniques (ART). In this case study, the investigators will evaluate changes in the bacterial ecology and inflammatory markers of the female uterus with different delivery modes. We will investigate whether the dominate endometrial microflora is interrupted by the Cesarean section in the infertile women undergoing ART, and the potential mechanism will also be further explored prospectively.

Detailed Description

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The highly prevalence of cesarean section rate in China had drawn great attention world widely. Post-cesarean section scar diverticulum ( PCSD) is a poor healing of the local incision after Cesarean section which happened in19.4%\~88% of patients. The cavity is formed by the original incision connected with the uterine cavity. Patients with diverticulum are often accompanied by prolonged menstruation and uterine effusion, which may accompany with endometrial inflammation and impair embryo implantation rate.

Though Cesarean section plays an important role in the treatment of dystocia and also decreasing perinatal mortality, it may impact natural conception and the success rate of ART in secondary infertile patients. Data from other researchers have revealed that Cesarean scar may related to poor pregnancy outcome during ART treatment. We have retrospectively analyzed the pregnancy outcome of ART treatment in patients who have had live birth previously from January 2014 to May 2018. The biochemical pregnancy rate, embryo implantation rate and clinical pregnancy rate are all lower in patients with Caesarean section compared to patients after natural labour, the clinical data is even worse in patients with PCSD. The results suggest a close correlation between the outcome of assisted reproductive therapy and the uterine condition. Further evaluations are required related to whether the dominate endometrial microflora is interrupted by the Cesarean section in the infertile women undergoing ART, and the potential mechanism will also be explored accordingly. A single-center, prospective, case-control study will be carried out.

Conditions

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Infertile Patients With Previous Live Birth

Keywords

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Secondary infertility, cesarean section, post-cesarean section scar diverticulum , endometrial microflora, inflammatory markers, clinical pregnancy, live birth

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Natural labour group

Hysteroscopy

Intervention Type OTHER

1. Three groups of patients will be enrolled: Natural labour group, Cesarean scar group and Cesarean with diverticulum (PCSD) group;
2. Hysteroscopy will be carried out for uterine cavity examine and the specimen collection for further microflora analysis and inflammation marker detection;
3. ART will be carried out with standard protocol and the clinical outcome will be recorded;
4. The primary outcome of the study is the comparation of species and communities of uterine microflora and inflammatory markers of the female uterus among three groups. The secondary outcome is biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate and live birth rate.

Cesarean scar group

Hysteroscopy

Intervention Type OTHER

1. Three groups of patients will be enrolled: Natural labour group, Cesarean scar group and Cesarean with diverticulum (PCSD) group;
2. Hysteroscopy will be carried out for uterine cavity examine and the specimen collection for further microflora analysis and inflammation marker detection;
3. ART will be carried out with standard protocol and the clinical outcome will be recorded;
4. The primary outcome of the study is the comparation of species and communities of uterine microflora and inflammatory markers of the female uterus among three groups. The secondary outcome is biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate and live birth rate.

Cesarean with diverticulum (PCSD) group

Hysteroscopy

Intervention Type OTHER

1. Three groups of patients will be enrolled: Natural labour group, Cesarean scar group and Cesarean with diverticulum (PCSD) group;
2. Hysteroscopy will be carried out for uterine cavity examine and the specimen collection for further microflora analysis and inflammation marker detection;
3. ART will be carried out with standard protocol and the clinical outcome will be recorded;
4. The primary outcome of the study is the comparation of species and communities of uterine microflora and inflammatory markers of the female uterus among three groups. The secondary outcome is biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate and live birth rate.

Interventions

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Hysteroscopy

1. Three groups of patients will be enrolled: Natural labour group, Cesarean scar group and Cesarean with diverticulum (PCSD) group;
2. Hysteroscopy will be carried out for uterine cavity examine and the specimen collection for further microflora analysis and inflammation marker detection;
3. ART will be carried out with standard protocol and the clinical outcome will be recorded;
4. The primary outcome of the study is the comparation of species and communities of uterine microflora and inflammatory markers of the female uterus among three groups. The secondary outcome is biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate and live birth rate.

Intervention Type OTHER

Other Intervention Names

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assisted reproductive medicine

Eligibility Criteria

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Inclusion Criteria

1. Women age ≥20 years and ≤40 years.
2. infertile Women with previously live birth.
3. Previous failed transfer cycle ≤2
4. Didn't participate in other clinical subjects within three months.
5. Written informed consent.

Exclusion Criteria

1. surgery history including: Ovariectomy, myomectomy, adenomyomectomy.
2. Uterine diseases including: uterine malformation, submucosal uterine fibroids and intrauterine adhesion.
3. One of couple has abnormal karyotype.
4. Recurrent abortion ≥2.
5. Untreated hydrosalpinx.
6. History of tuberculosis (pulmonary tuberculosis, pelvic tuberculosis etc.).
Minimum Eligible Age

20 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Sun Yat-sen University

OTHER

Sponsor Role lead

Responsible Party

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Yanhong Deng

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xing Yang, M.D. & Ph.D

Role: STUDY_CHAIR

The Sixth Affiliated Hospital, Sun Yat-sen University

Xaoyan Liang, M.D. & Ph.D

Role: STUDY_DIRECTOR

The Sixth Affiliated Hospital, Sun Yat-sen University

Locations

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The Sixth Affiliated Hospital,Sun Yat-Sen University

Guandong, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xing Yang, M.D. & Ph.D

Role: CONTACT

Phone: 020-38048013

Email: [email protected]

Xing Yang, M.D. & Ph.D

Role: CONTACT

Phone: 020-38048010

Other Identifiers

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newivf20190807

Identifier Type: -

Identifier Source: org_study_id