Umbilical Cord Plasma for Treating Endometrial Pathologies (Thin Endometrium / Asherman's Syndrome/ Endometria Atrophy).
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- 入组人数
- 15
- 试验地点
- 1
- 主要终点
- Study of endometrial regeneration and/or improvement in patients with endometrial pathologies (thin endometrium/Asherman's syndrome/endometrial atrophy) treated with platelet-rich plasma from the umbilical cord by endometrial thickeness.
研究概览
简要总结
In the last years, platelet-rich plasma (PRP) has emerged as a promising alternative to treat endometrial pathologies affecting the endometrial lining. Different studies have tried this therapeutic approach in human patient, but results are not conclusive at all. Also, in the last years, different studies have suggested the umbilical cord blood has a stronger reservoir of growth factors and other pro-regenerative molecules than the adult peripheral blood. That is the reason why the present study aims to evaluate if using platelet-rich plasma obtained from umbilical cord blood is able to increase endometrial thickness and prepare the endometrium for an embryo transference. However, due to the novelty of this approach, the investigators have considered to include a 'proof of concept' group (women with premature ovarian insufficiency) to obtain a deeper understanding of the clinical value of this blood derivative.
详细描述
Phase II clinical trial, designed as a pilot study, single-center and open-label, which aims to study the efficacy of platelet-rich plasma from umbilical cord after injection into a pathological endometrium (thin endometrium, Asherman's Syndrome, endometrial atrophy).
This treatment will be applied to patients with the aforementioned endometrial pathologies (group B), as well as to patients with premature ovarian failure (group A), which will serve to study its clinical value in greater detail. Plasma samples as well as endometrial biopsies will be analyzed to try to understand what molecular events are triggered in the endometrial tissue after the application of the treatment under study.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 48 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Patient information sheet and signed informed consent.
- •Female, acting voluntarily, aged between 18 and 48 years at the time of recruitment.
- •BMI ≥ 18 kg/m2 and ≤ 35 kg/m
- •Patients with premature ovarian failure (amenorrhea prior to 40 years of age and FSH > 40 IU/L).
排除标准
- •Active genital infection proven at the time of recruitment; chronic endometritis.
- •Known endometrial pathology.
- •Psychological disorder that may hinder study follow-up.
- •Positive results after viral safety analysis (HBsAg, HBcAb, HCV, HIV1, HIV2, syphilis).
- •Presenting any syndrome or condition that, from the principal investigator's point of view, could pose a risk to the study or to the patient.
- •Any significant clinical anomaly detected during the recruitment process; simultaneous participation in another clinical study that could affect the objectives of the present study or previous participation in this same study.
- •Inclusion Criteria:
- •Information and signed informed consent.
- •female, acting voluntarily, aged between 18 and 48 years at the time of recruitment.
- •body mass index (BMI): ≥ 18 kg/m2 and ≤ 35 kg/m
- •Patients undergoing an assisted reproduction cycle.
- •Endometrial thickness < 5mm despite estrogen administration for more than 10 days and/or evidence of Asherman's Syndrome.
- •Exclusion Criteria:
- •Active genital infection proven at the time of recruitment; chronic endometritis.
- •Known endometrial pathology.
- •Psychological disorder that may hinder study follow-up.
- •Positive results after viral safety analysis (HBsAg, HBcAb, HCV, HIV1, HIV2, syphilis).
- •Presenting any syndrome or condition that, from the principal investigator's point of view, could pose a risk to the study or to the patient.
- •Any significant clinical anomaly detected during the recruitment process; simultaneous participation in another clinical study that could affect the objectives of the present study or previous participation in this same study.
研究组 & 干预措施
Umbilical cord PRP donors
Women who are going to give birth to a healthy live newborn at the Hospital Universitario y Politécnico La Fe.
Donors will donate their umbilical cord blood to obtain the hUC-PRP. A total of 30±15 donors will be recruited.
干预措施: Umbilical cord blood collection (Procedure)
Group B- Asherman with PRP treatment and estrogen therapy
Women with thin endometrium/endometrial atrophy and/or Asherman's syndrome with fertility problems and reproductive desires, desires that could be achieved by their participation in the present study. A total of 15 patients will be included; all of them will receive the investigational treatment as well as estrogen therapy.
干预措施: Injection of hUC-PRP by hysteroscopy (Procedure)
Group B- Asherman with PRP treatment and estrogen therapy
Women with thin endometrium/endometrial atrophy and/or Asherman's syndrome with fertility problems and reproductive desires, desires that could be achieved by their participation in the present study. A total of 15 patients will be included; all of them will receive the investigational treatment as well as estrogen therapy.
干预措施: Oestraclin (Drug)
Group B- Asherman with PRP treatment and estrogen therapy
Women with thin endometrium/endometrial atrophy and/or Asherman's syndrome with fertility problems and reproductive desires, desires that could be achieved by their participation in the present study. A total of 15 patients will be included; all of them will receive the investigational treatment as well as estrogen therapy.
干预措施: Endometrial biopsy (Procedure)
Group A1- POI with PRP treatment and estrogen therapy
Women with premature ovarian failure (POI). A total of 10 patients will be included. All of them will receive the investigational treatment as well as estrogen therapy.
干预措施: Injection of hUC-PRP by hysteroscopy (Procedure)
Group A1- POI with PRP treatment and estrogen therapy
Women with premature ovarian failure (POI). A total of 10 patients will be included. All of them will receive the investigational treatment as well as estrogen therapy.
干预措施: Oestraclin (Drug)
Group A1- POI with PRP treatment and estrogen therapy
Women with premature ovarian failure (POI). A total of 10 patients will be included. All of them will receive the investigational treatment as well as estrogen therapy.
干预措施: Endometrial biopsy (Procedure)
Group A2- POI with estrogen therapy
Women with premature ovarian failure (POI). A total of 10 patients will be included. All of them will receive the estrogen therapy.
干预措施: Oestraclin (Drug)
Group A2- POI with estrogen therapy
Women with premature ovarian failure (POI). A total of 10 patients will be included. All of them will receive the estrogen therapy.
干预措施: Endometrial biopsy (Procedure)
Group A3- POI without PRP treatment nor estrogen therapy
Women with premature ovarian failure (POI). A total of 10 patients will be included. None of them will receive either the investigational treatment nor estrogen therapy.
干预措施: Endometrial biopsy (Procedure)
结局指标
主要结局
Study of endometrial regeneration and/or improvement in patients with endometrial pathologies (thin endometrium/Asherman's syndrome/endometrial atrophy) treated with platelet-rich plasma from the umbilical cord by endometrial thickeness.
时间窗: An average of 3 months
Improvement will be studied in form of tissue thickening (mm), comparing endometrial thickness before and after PRP injection
次要结局
- Proof-of-concept in POI patients by improvement endometrial thickeness.(An average of 3 months)
- Gene and protein level evaluation of the endometrial biopsies collected.(An average of 3 years)
- Study of the molecular composition of the different plasma fractions obtained from collected umbilical cord samples.(An average of 3 years)