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Microfluidic Chip vs Density Gradient Centrifugation on the Euploidy Rate of Pre-implantation Genetic Testing

Primary Purpose

Infertility, Genetic Disease, Chromosomal Rearrangement

Status
Not yet recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
microfluidic chip
density gradient centrifugation
Sponsored by
Professor Ernest Hung-Yu Ng
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Infertility focused on measuring microfluidic chip, density gradient centrifugation, euploidy rate, pre-implantation genetic testing

Eligibility Criteria

undefined - 43 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Women aged <43 years at the time of ovarian stimulation for IVF Women undergoing PGT for monogenic diseases, structural rearrangement of chromosomes or aneuploidy Sperm concentration of the raw semen with at least 0.15 million motile sperm per ml or 100 motile sperm per 50 low power field (200x) of observation Exclusion Criteria: Use of frozen semen for insemination Use of donor oocytes and spermatozoa Submucosal fibroid or hydrosalpinx shown on pelvic scanning and not surgically treated; Women who had been recruited into this study before and Women joining other randomized trials

Sites / Locations

  • Department of Obstetrics and Gynaecology

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

The microfluidic chip group

The density gradient centrifugation group

Arm Description

The Sperm Separation Device - ZyMōt Multi 850µL or 3 mL device (ZyMōt Fertility, Inc) will be used according to the volume of the raw semen samples. The microfluidics chamber will be used based on the manufacturer's instructions. 850 μL (850 μL device) or 3 mL (3mL device) of the semen sample will be added to the inlet port of the device and 750 μL (850 μL device) or 2.4 mL (3 mL device) of fertilization media will be added to the outlet port. The device will then be incubated in 6% CO2 at 37°C. After 30 minutes, 500 μL (850 μL device) or 1 mL (3mL device) of the prepared sample at the outlet port will be removed and pipetted into a labelled test tube.

After liquefaction, sperm preparation will be completed by a discontinuous density gradient centrifugation method, using Pureception (CooperSurgical, Denmark) sperm density gradient media. The resulting sperm pellet after centrifugation will be washed once with the sperm washing medium (G-IVF Plus, Vitrolife, Sweden) The washed spermatozoa will be resuspended with the same medium, adjusting the final volume to 0.5 mL.

Outcomes

Primary Outcome Measures

Euploid rate of blastocysts
Euploid rate of blastocysts biopsied

Secondary Outcome Measures

Live birth rate of the first embryo transfer
No. of live birth beyond 22 weeks of gestation per the first embryo transfer
Positive urine pregnancy test rate per the first embryo transfer
No. of positive urine pregnancy test per the first embryo transfer
Clinical pregnancy rate of the first embryo transfer
No. of clinical pregnancy per the first embryo transfer defined as presence of intrauterine gestational sac on scanning at gestational week 6.
Ongoing pregnancy rate
No. of ongoing pregnancy as presence of a fetal pole with pulsation at 8-10 weeks of gestation
Miscarriage rate pregnancy
No. of miscarriage defined as a clinically recognized pregnancy loss before the 22 weeks of pregnancy and whose denominator is the clinical pregnancy.
Multiple pregnancy rate
Multiple pregnancy rate: presence of more than one intrauterine sac at 6 weeks of gestation
DNA fragmentation
Measurement of DNA fragmentation by Comet assay using the Olive tail moment as the quantitative metric.
Ectopic pregnancy rate
No. of ectopic pregnancy

Full Information

First Posted
June 29, 2023
Last Updated
August 28, 2023
Sponsor
Professor Ernest Hung-Yu Ng
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1. Study Identification

Unique Protocol Identification Number
NCT06023472
Brief Title
Microfluidic Chip vs Density Gradient Centrifugation on the Euploidy Rate of Pre-implantation Genetic Testing
Official Title
A Randomized Comparison of Microfluidic Chip vs Density Gradient Centrifugation on the Euploidy Rate of Pre-implantation Genetic Testing
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 1, 2023 (Anticipated)
Primary Completion Date
September 30, 2027 (Anticipated)
Study Completion Date
December 31, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Professor Ernest Hung-Yu Ng

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
Infertile women attending for PGT at the Centre of Assisted Reproduction and Embryology, Queen Mary Hospital and Kwong Wah Hospital will be recruited during ovarian stimulation for IVF. Subsequently, they will be randomly assigned on the day of oocyte retrieval by a laboratory staff into one of the following two groups in a 1:1 ratio : (1) the microfluidic chip group and (2) the density gradient centrifugation group for sperm preparation and subsequent use in fertilization. Other IVF procedures will be the same as the standard practice of the Centre. Both women and clinicians will be blinded from the group allocation i.e. a double blind study.
Detailed Description
The study aims to investigate the treatment of couples undergoing in vitro fertilization (IVF). Eligible couples will be recruited for the study after providing informed written consent following counseling. The IVF protocol involves various steps. Women will undergo preimplantation genetic testing (PGT) as clinically indicated. Ovarian stimulation will be carried out using gonadotropin injections, and regular ultrasound monitoring will be conducted to track the growth of follicles. To prevent a premature LH surge, progestin primed ovarian stimulation or a GnRH antagonist will be administered. Once at least three follicles reach a size of over 17 mm, a trigger injection of either human chorionic gonadotrophin or a GnRH agonist will be given to induce final maturation. Oocyte retrieval will be performed 36 hours after the trigger under transvaginal ultrasound guidance. The recruited women will be randomly assigned to one of two groups: the microfluidic chip group or the density gradient centrifugation group. Randomization and blinding will be ensured to maintain the integrity of the study. Only the laboratory staff involved in sperm preparation will be aware of the group assignment, while the women and clinicians will be blinded to the treatment groups. Semen specimens will be collected by masturbation on the day of oocyte retrieval, following a period of 2-7 days of sexual abstinence. The semen samples will undergo evaluation according to WHO guidelines, including semen volume, sperm concentration, and percent motile spermatozoa. Sperm DNA damage will be assessed using an alkaline single-cell gel electrophoresis (Comet) assay. The extent of DNA damage in spermatozoa will be examined using specific parameters. Sperm preparation will be performed based on the randomization list. In the microfluidic chip group, the Sperm Separation Device will be used, and the prepared sample will be collected in a test tube. In the density gradient centrifugation group, sperm preparation will be completed using a discontinuous density gradient centrifugation method, and the resulting sperm pellet will be washed and resuspended. Oocytes will be fertilized through intracytoplasmic sperm injection, and normal fertilization will be confirmed by the presence of two pronuclei. A few cells will be taken from the blastocysts for comprehensive chromosome analysis. Cryopreservation of all blastocysts will be done, and only euploid blastocysts without aneuploidies will be replaced in subsequent frozen embryo transfer cycles. Frozen embryo transfer (FET) will be performed in subsequent natural or hormonal replacement cycles, depending on the women's menstrual cycle regularity. Pregnancy outcomes will be monitored through urine pregnancy tests and transvaginal ultrasounds. If the pregnancy test is positive, further ultrasounds will be done to confirm fetal viability and the number of fetuses. Pregnancy and delivery data will be retrieved after delivery, and information on pregnancy outcomes, number of babies born, birth weights, and obstetric complications will be recorded. The study aims to assess the effectiveness of the two different sperm preparation methods and their impact on IVF outcomes, including pregnancy rates and obstetric complications.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infertility, Genetic Disease, Chromosomal Rearrangement, Aneuploidy
Keywords
microfluidic chip, density gradient centrifugation, euploidy rate, pre-implantation genetic testing

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
On the day of oocyte retrieval, recruited women will be randomly assigned into one of the following two groups according to a computer-generated randomization list with a 1:1 ratio and a block size of 10. The randomization list will be prepared by a designated research nurse who is not involved in care of the women and opened by a laboratory staff. The microfluidic chip group and The density gradient centrifugation group
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
On the day of oocyte retrieval, recruited women will be randomly assigned into one of the following two groups according to a computer-generated randomization list with a 1:1 ratio and a block size of 10. The randomization list will be prepared by a designated research nurse who is not involved in care of the women and opened by a laboratory staff. The microfluidic chip group and The density gradient centrifugation group The women and clinicians will be blinded to the treatment groups they are assigned. Only the laboratory staff in the IVF laboratory performing sperm preparation will be aware of the group assignment.
Allocation
Randomized
Enrollment
318 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
The microfluidic chip group
Arm Type
Experimental
Arm Description
The Sperm Separation Device - ZyMōt Multi 850µL or 3 mL device (ZyMōt Fertility, Inc) will be used according to the volume of the raw semen samples. The microfluidics chamber will be used based on the manufacturer's instructions. 850 μL (850 μL device) or 3 mL (3mL device) of the semen sample will be added to the inlet port of the device and 750 μL (850 μL device) or 2.4 mL (3 mL device) of fertilization media will be added to the outlet port. The device will then be incubated in 6% CO2 at 37°C. After 30 minutes, 500 μL (850 μL device) or 1 mL (3mL device) of the prepared sample at the outlet port will be removed and pipetted into a labelled test tube.
Arm Title
The density gradient centrifugation group
Arm Type
Active Comparator
Arm Description
After liquefaction, sperm preparation will be completed by a discontinuous density gradient centrifugation method, using Pureception (CooperSurgical, Denmark) sperm density gradient media. The resulting sperm pellet after centrifugation will be washed once with the sperm washing medium (G-IVF Plus, Vitrolife, Sweden) The washed spermatozoa will be resuspended with the same medium, adjusting the final volume to 0.5 mL.
Intervention Type
Device
Intervention Name(s)
microfluidic chip
Intervention Description
Microfluidic chip method has been used for sperm sorting in order to select the most motile and morphologically normal sperm for use in assisted reproductive technologies (ART) such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).
Intervention Type
Device
Intervention Name(s)
density gradient centrifugation
Intervention Description
Density-gradient centrifugation is a commonly used method for sperm separation and purification. It is a technique that involves layering a semen sample on top of a gradient of different densities of a solution, typically a mixture of colloidal silica and sucrose, and then centrifuging the sample. The centrifugal force causes the sperm to migrate through the gradient, where they become separated based on their density.
Primary Outcome Measure Information:
Title
Euploid rate of blastocysts
Description
Euploid rate of blastocysts biopsied
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Live birth rate of the first embryo transfer
Description
No. of live birth beyond 22 weeks of gestation per the first embryo transfer
Time Frame
3 years
Title
Positive urine pregnancy test rate per the first embryo transfer
Description
No. of positive urine pregnancy test per the first embryo transfer
Time Frame
3 years
Title
Clinical pregnancy rate of the first embryo transfer
Description
No. of clinical pregnancy per the first embryo transfer defined as presence of intrauterine gestational sac on scanning at gestational week 6.
Time Frame
3 years
Title
Ongoing pregnancy rate
Description
No. of ongoing pregnancy as presence of a fetal pole with pulsation at 8-10 weeks of gestation
Time Frame
3 years
Title
Miscarriage rate pregnancy
Description
No. of miscarriage defined as a clinically recognized pregnancy loss before the 22 weeks of pregnancy and whose denominator is the clinical pregnancy.
Time Frame
3 years
Title
Multiple pregnancy rate
Description
Multiple pregnancy rate: presence of more than one intrauterine sac at 6 weeks of gestation
Time Frame
3 years
Title
DNA fragmentation
Description
Measurement of DNA fragmentation by Comet assay using the Olive tail moment as the quantitative metric.
Time Frame
3 years
Title
Ectopic pregnancy rate
Description
No. of ectopic pregnancy
Time Frame
3 years

10. Eligibility

Sex
All
Maximum Age & Unit of Time
43 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Women aged <43 years at the time of ovarian stimulation for IVF Women undergoing PGT for monogenic diseases, structural rearrangement of chromosomes or aneuploidy Sperm concentration of the raw semen with at least 0.15 million motile sperm per ml or 100 motile sperm per 50 low power field (200x) of observation Exclusion Criteria: Use of frozen semen for insemination Use of donor oocytes and spermatozoa Submucosal fibroid or hydrosalpinx shown on pelvic scanning and not surgically treated; Women who had been recruited into this study before and Women joining other randomized trials
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
YU WING TONG, MBBS
Phone
92707722
Email
ptong@connect.hku.hk
Facility Information:
Facility Name
Department of Obstetrics and Gynaecology
City
Hong Kong
State/Province
Hong Kong
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Microfluidic Chip vs Density Gradient Centrifugation on the Euploidy Rate of Pre-implantation Genetic Testing

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