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Management of Abnormally Fertilized Zygotes? InVitro Correction of 3PN

Primary Purpose

Infertility

Status
Completed
Phase
Early Phase 1
Locations
International
Study Type
Interventional
Intervention
Correction of abnormally fertilized oocytes
Sponsored by
Ahmad Mustafa Mohamed Metwalley
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Infertility focused on measuring Abnormal zygote fertilization, 3PNs correction, Giant oocyte management, triploidy fertilization, Maternal nucleus removal

Eligibility Criteria

20 Years - 45 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Giant oocytes
  • 3 PNs developed embryos at day 1 post ICSI.

Exclusion Criteria:

  • Patient refused to involving their abnormal oocytes at our study.

Sites / Locations

  • Al Baraka Fertility Hospital
  • Ibn Sina IVF Center- Ibn Sina Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Giant Oocytes after ICSI

3PNs zygotes developed after ICSI

Arm Description

abnormally produced oocyte after ART or Controlled ovarian stimulation. Correction of abnormally fertilized oocytes using nucleus removal.

Abnormally developed embryos these produced 3PNs. Correction of abnormally fertilized oocytes using nucleus removal.

Outcomes

Primary Outcome Measures

Normal Embryos Developed
At 18 hours after ICSi nucleus to be removed in-order to make genetic correction for abnormally developed embryos. Final result is normal embryos produced with 2PNs evaluated by FSIH study for 5 chromosomes. This indicated the genetic correction process was successful process, and applicable to produce normal growing embryos.

Secondary Outcome Measures

Day 3 embryo available for blastomer biopsy
Availability of successful nucleus removal from zygote to be developed to active dividing embryo available for cytogenetic study. That indicated normal embryogenesis processing
5 chromosomes FISH study
chromosomes 13, 18, 21, X and Y to be screened using fluorescence insitu hybridization (FISH). In order to check primary euploid developed with male (XY) or female (XX) embryos.

Full Information

First Posted
January 15, 2015
Last Updated
January 11, 2016
Sponsor
Ahmad Mustafa Mohamed Metwalley
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1. Study Identification

Unique Protocol Identification Number
NCT02358759
Brief Title
Management of Abnormally Fertilized Zygotes? InVitro Correction of 3PN
Official Title
Treatment of Abnormally Multinucleated Zygotes Before Before Division Starting.
Study Type
Interventional

2. Study Status

Record Verification Date
January 2016
Overall Recruitment Status
Completed
Study Start Date
June 2014 (undefined)
Primary Completion Date
September 2015 (Actual)
Study Completion Date
September 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Ahmad Mustafa Mohamed Metwalley

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
In this newly developed protocol, and idea, is to manage those abnormally developed zygotes from different ART procedures. The investigators developed the plan and requirements needed to select the target extra nucleus or pronuclei to be extruded from fertilized egg in order to maintain developing healthy normal embryo.
Detailed Description
As approved by Dyban and Baranov et al, about 15-18% of abortions caused by triploidy fertilization. One of sources for maternally triploidy is failure in the first meiotic division (Jacobs et al., 1978). One of Digynic triploidy is developed by fertilized giant oocyte (Dyban and Baranov, 1987) {nuclear but no cytoplasmic division in an oogonium or cytoplasmic fusion of two oogonia (Austin, 1960)}. Giant oocyte characterized with bigger diameter and will distinguished polar bodies at metaphase II. B. Rosenbusch et. al. 2002, cytogenetic study showed that extra haploid maternal copy associated with MII (46,XX/ 2N ) giant oocytes as well as triploidy with fertilized giant oocytes (3N with 69,XXX or 69,XXY). First Mitotic division plane with polar axes studies by Scott, 2001 , shows that Pn developed closer to 2nd polar body is the maternal origin PN. Giant oocytes were collected from different IVF cycles, to be injected with normal sperm using Intracytoplasmic sperm injection (ICSI). 18 hours post ICSI arranged for fertilization evaluation and PN removal for fertilized oocyte before syngamy starts. Video attached shows process of zygote manipulation by the way avoiding the division axis and focusing the extra maternal PN to be aspirated. Pronuclear transfer in human embryos for mitochondrial DNA correction started the methodology of pronuclear manipulation, for that possibility of utilizing of 3PNs developed embryos research tools can be started. We arranged to study available received giant oocytes during IVF cycles. Accordingly we arranged for pronuclear removal followed by FISH evaluation in order to targeting Normal males embryos that insure proper extra maternal pronucleus removal. Successful trials of maternal PN removal for giant oocyte collected from different cases summarized in table 1. All blastocyst developed arranged for FISH, so all embryos were utilized for cytogenetic evaluation. Recommendations: Further evaluations using STRs (Short tandem repeat ) should be used for maternal-paternal genome differentiation. NGS study is under evaluation for developed embryos for full CCS reporting and more genetic integrity. Epigenetic evaluation study recommended for triploidy corrected embryos for genetic expressions and early embryo developments as well as differentiation between paternal and maternal genomic activity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infertility
Keywords
Abnormal zygote fertilization, 3PNs correction, Giant oocyte management, triploidy fertilization, Maternal nucleus removal

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
Outcomes Assessor
Allocation
Non-Randomized
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Giant Oocytes after ICSI
Arm Type
Active Comparator
Arm Description
abnormally produced oocyte after ART or Controlled ovarian stimulation. Correction of abnormally fertilized oocytes using nucleus removal.
Arm Title
3PNs zygotes developed after ICSI
Arm Type
Active Comparator
Arm Description
Abnormally developed embryos these produced 3PNs. Correction of abnormally fertilized oocytes using nucleus removal.
Intervention Type
Procedure
Intervention Name(s)
Correction of abnormally fertilized oocytes
Intervention Description
Removing of extra developed nucleus from fertilized oocyte.
Primary Outcome Measure Information:
Title
Normal Embryos Developed
Description
At 18 hours after ICSi nucleus to be removed in-order to make genetic correction for abnormally developed embryos. Final result is normal embryos produced with 2PNs evaluated by FSIH study for 5 chromosomes. This indicated the genetic correction process was successful process, and applicable to produce normal growing embryos.
Time Frame
Day 1 or 18 hours post ICSI nucleus removal
Secondary Outcome Measure Information:
Title
Day 3 embryo available for blastomer biopsy
Description
Availability of successful nucleus removal from zygote to be developed to active dividing embryo available for cytogenetic study. That indicated normal embryogenesis processing
Time Frame
1 Year
Title
5 chromosomes FISH study
Description
chromosomes 13, 18, 21, X and Y to be screened using fluorescence insitu hybridization (FISH). In order to check primary euploid developed with male (XY) or female (XX) embryos.
Time Frame
1 Year
Other Pre-specified Outcome Measures:
Title
Blastocyst development
Description
availability of embryos to develop for day 5 giving chance for better cells evaluation and more genetic and cytogenetic studies.
Time Frame
Day 5 embryo development for blastocyst stage

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Giant oocytes 3 PNs developed embryos at day 1 post ICSI. Exclusion Criteria: Patient refused to involving their abnormal oocytes at our study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ahmad M Metwalley
Organizational Affiliation
Al Baraka Fertility Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Al Baraka Fertility Hospital
City
Manama
State/Province
Adliyah
ZIP/Postal Code
15006
Country
Bahrain
Facility Name
Ibn Sina IVF Center- Ibn Sina Hospital
City
Sohag
ZIP/Postal Code
15006
Country
Egypt

12. IPD Sharing Statement

Citations:
PubMed Identifier
686684
Citation
Jacobs PA, Angell RR, Buchanan IM, Hassold TJ, Matsuyama AM, Manuel B. The origin of human triploids. Ann Hum Genet. 1978 Jul;42(1):49-57. doi: 10.1111/j.1469-1809.1978.tb00930.x.
Results Reference
result
PubMed Identifier
23271027
Citation
Rosenbusch B. The potential significance of binovular follicles and binucleate giant oocytes for the development of genetic abnormalities. J Genet. 2012;91(3):397-404. doi: 10.1007/s12041-012-0195-x.
Results Reference
result
PubMed Identifier
25573721
Citation
Wolf DP, Mitalipov N, Mitalipov S. Mitochondrial replacement therapy in reproductive medicine. Trends Mol Med. 2015 Feb;21(2):68-76. doi: 10.1016/j.molmed.2014.12.001. Epub 2014 Dec 10.
Results Reference
result
PubMed Identifier
24558137
Citation
Vogel G. Assisted reproduction. FDA considers trials of 'three-parent embryos'. Science. 2014 Feb 21;343(6173):827-8. doi: 10.1126/science.343.6173.827. No abstract available.
Results Reference
result
PubMed Identifier
24382342
Citation
Amato P, Tachibana M, Sparman M, Mitalipov S. Three-parent in vitro fertilization: gene replacement for the prevention of inherited mitochondrial diseases. Fertil Steril. 2014 Jan;101(1):31-5. doi: 10.1016/j.fertnstert.2013.11.030.
Results Reference
result

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Management of Abnormally Fertilized Zygotes? InVitro Correction of 3PN

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