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Is the AMH Intrafollicular Level a Predictor of the Ploidy Status of the Blastocyst?

Recruiting
Conditions
Infertility
Infertility, Female
Interventions
Procedure: ICSI
Procedure: Oocyte Pick Up - Out of Study
Procedure: Denudation - Out of Study
Procedure: Culture
Procedure: Vitrification
Genetic: Biopsy
Procedure: OPU - Study Group
Procedure: Denudation - Study Group
Registration Number
NCT05837325
Lead Sponsor
ART Fertility Clinics LLC
Brief Summary

To investigate, whether on the day of egg retrieval, after ovarian stimulation for ICSI (intracytoplasmic sperm injection), there is a correlation between the intrafollicular AMH (Anti-Müllerian hormone) levels and the ploidy status of the blastocyst.

Detailed Description

In clinical practice, AMH is used as a diagnostic and/or prognostic marker in women in association with ovulation induction and in various pathophysiological conditions. This study looks to investigate if the hormonal environment that surrounds an oocyte has an impact on the ploidy status of the blastocyst. Nowadays, using NGS (Next Generation Sequencing) platform for analysis of 23 pairs of chromosomes for Preimplantation Genetic Testing on blastocysts, the ploidy status of the embryo is more adequately assessed. Furthermore, embryo culture to blastocyst will provide further information about embryo quality and possibilities of implantation.

To have complete information between the serum hormones, follicular hormones, embryo development and ploidy will provide to clinicians, embryologist and patients further information on embryo selection and adequate ovarian stimulation protocols.

The database will be exported from the clinical information manager, VRepro, to a table in excel format through a database-based query system. The exported data will be duly codified to protect the clinical and personal information of the participants. Prior to the statistical study, an exploratory data analysis will be carried out to review the quality of the information extracted.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
300
Inclusion Criteria
  • At least one follicle from each ovary at day of trigger
  • Age from 18 to 40 years old
  • Normal menstrual cycle of 25-35 days
  • Poor, normal and high response will be included
  • First follicle punctured from each ovary will be consider for inclusion: if the COC (Cumulus Oocyte Complex) is present in clear FF (Follicular fluid), the FF will be collected separately for further analysis and the oocyte included in the study
Exclusion Criteria
  • Very hematic follicular fluid
  • If the COC is not found in the follicular fluid
  • Azoospermia
  • Known chromosomal abnormalities
  • Severe OAT (Oligoasthenoteratozoospermia)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Study GroupVitrification-
Out of Study GroupDenudation - Out of Study-
Out of Study GroupBiopsy-
Study GroupBiopsy-
Study GroupOPU - Study Group-
Study GroupICSI-
Study GroupCulture-
Out of Study GroupICSI-
Out of Study GroupCulture-
Study GroupDenudation - Study Group-
Out of Study GroupOocyte Pick Up - Out of Study-
Out of Study GroupVitrification-
Primary Outcome Measures
NameTimeMethod
Oocyte maturity1 day

Calculated as percentage transformation of an oocyte from prophase I to metaphase II

Fertilization1 day

Percentage of mature oocytes - metaphase II (MII) that become 2 pronucleii embryos (2PN)

Blastulation1 day

Ability of the embryo to form a cavity (=to blastulate) 114-118 hours post ICSI. Number of blastocysts divided by the number of 2PN

Blastocyst quality6 days

Four Embryo Quality Scores (EQ1, 2, 3, 4) based on the expansion stage of the blastocyst, the grade of the inner cell mass and the grade of the trophectoderm.

Ploidy status14 days

Determined after biopsy of trophectoderm cells, taken from the blastocyst on day 5, 6 or 7 from development

Mitochondria status14 days

Measured as mtDNA ratio, the ratio of mitochondrial DNA (mtDNA) read counts to autosomal (chromosome 1-22) DNA read counts

Secondary Outcome Measures
NameTimeMethod
P4 in the follicular fluid.1 day

To evaluate if there is an association between serum P4 on day 2-3 of the stimulation, serum P4 day of OPU and the intra-follicular P4.

FSH in serum day of OPU1 day

To evaluate if there is an association between serum FSH on day 2-3 of the stimulation, serum FSH day of OPU and the intra-follicular FSH.

LH in serum day of OPU1 day

To evaluate if there is an association between serum LH on day 2-3 of the stimulation, serum LH day of OPU and the intra-follicular LH.

AMH in serum day of day 2/3 of stimulation.1 day

To evaluate if there is an association between the levels of serum AMH on day 2-3 of the stimulation, AMH day of OPU and the intra-follicular AMH.

P4 in serum day of day 2/3 of stimulation.1 day

To evaluate if there is an association between serum P4 on day 2-3 of the stimulation, serum P4 day of OPU and the intra-follicular P4.

LH in the follicular fluid.1 day

To evaluate if there is an association between serum LH on day 2-3 of the stimulation, serum LH day of OPU and the intra-follicular LH.

E2 in the follicular fluid.1 day

To evaluate if there is an association between serum E2 on day 2-3 of the stimulation, serum E2 day of OPU and the intra-follicular E2.

Inhibin B in serum day of day 2/3 of stimulation.1 day

To evaluate if there is an association between serum Inhibin B on day 2-3 of the stimulation, serum Inhibin B day of OPU and the intra-follicular Inhibin B.

Inhibin B in the follicular fluid.1 day

To evaluate if there is an association between serum Inhibin B on day 2-3 of the stimulation, serum Inhibin B day of OPU and the intra-follicular Inhibin B.

P4 in serum day of OPU1 day

To evaluate if there is an association between serum P4 on day 2-3 of the stimulation, serum P4 day of OPU and the intra-follicular P4.

Inhibin B in serum day of OPU1 day

To evaluate if there is an association between serum Inhibin B on day 2-3 of the stimulation, serum Inhibin B day of OPU and the intra-follicular Inhibin B.

AMH in the follicular fluid.1 day

To evaluate if there is an association between the levels of serum AMH on day 2-3 of the stimulation, AMH day of OPU and the intra-follicular AMH.

FSH in the follicular fluid.1 day

To evaluate if there is an association between serum FSH on day 2-3 of the stimulation, serum FSH day of OPU and the intra-follicular FSH.

AMH in serum day of OPU1 day

To evaluate if there is an association between the levels of serum AMH on day 2-3 of the stimulation, AMH day of OPU and the intra-follicular AMH.

LH in serum day of day 2/3 of stimulation.1 day

To evaluate if there is an association between serum LH on day 2-3 of the stimulation, serum LH day of OPU and the intra-follicular LH.

E2 in serum day of day 2/3 of stimulation.1 day

To evaluate if there is an association between serum E2 on day 2-3 of the stimulation, serum E2 day of OPU and the intra-follicular E2.

E2 in serum day of OPU1 day

To evaluate if there is an association between serum E2 on day 2-3 of the stimulation, serum E2 day of OPU and the intra-follicular E2.

FSH in serum day of day 2/3 of stimulation.1 day

To evaluate if there is an association between serum FSH on day 2-3 of the stimulation, serum FSH day of OPU and the intra-follicular FSH.

Trial Locations

Locations (1)

ART Fertility Clinics LLC

🇦🇪

Abu Dhabi, United Arab Emirates

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