AzTrials
AzTrials

Reproductive SterilityNCT02935738

Prednisolone Improves IVF Outcomes in Men With Anti-sperm Antibodies

A study testing Prednisolone treatment in people with Reproductive Sterility, run by Barz IVF Center for Infertility Treatment and Embryo Research.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Corticosteroids have been indicated to treat men with ASAs. Although many studies have confirmed the clinical therapeutic significance of corticosteroids in the treatment of men with ASAs, other studies have not found a therapeutic significance for corticosteroids in the treatment of men with ASAs. Read more about this study

Who is it for?
Ages 25 to 45 years
Conditions the study is for
Reproductive Sterility
What is being tested?
Prednisolone treatment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
241 participants
Where
No sites listed yet
Study dates
Oct 2014to May 2016
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 25 to 45 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Female partners had complete or partial tubal patency
  • Male partners with anti-sperm antibodies
  • Male partners with sperm count > 35 million/ml.

Who cannot join

  • Female partners with polycystic ovary
  • Female partners with endometriosis
  • Female partners with abnormal profile of reproductive hormones
  • Female partners with abnormal profile of thyroid hormones
  • Male partners with seminal fluid infections (e.g. leukospermia)
  • Male partners with abnormal profile of reproductive hormones
  • Male partners with abnormal profile of thyroid hormones

About this study

Official title: Improvement in Pregnancy Outcomes in Immunologically Infertile Male Patients Undergoing Prednisolone Treatment and Conventional IVF Preceded by Sperm Penetration Assay: A Randomized Controlled Trial

Corticosteroids have been indicated to treat men with ASAs. Although many studies have confirmed the clinical therapeutic significance of corticosteroids in the treatment of men with ASAs, other studies have not found a therapeutic significance for corticosteroids in the treatment of men with ASAs. Moreover, although some reports have shown high fertilization and conception rates in couples when husbands did not have ASAs, other reports have shown that ASAs do not have a negative effect on fertilization and conception rates. These contradictory results have left the therapeutic effect of corticosteroids in men with ASA in continuing controversy. This controversy is also extended to include the usefulness of assisted reproductive technology (ART) in the treatment of patients with ASAs. In this regard, although some studies have shown that the pregnancy rate following in vitro fertilization (IVF) or intracellular sperm injection (ICSI) were similar in men with or without ASA or did not associate with ASA, others reported the superiority of ICSI over IVF and intrauterine insemination over natural intercourse in men with ASAs. It is possible that some patients with ASAs also have an additional problem(s) related to sperm binding to the oolemma and fusion into the ovum as well as sperm head decondensation. The latter condition may negatively influence or mask the clinical significance of corticosteroids on pregnancy rates in patients with ASAs. Some patients might not have benefited from corticosteroids and conventional IVF treatments due to the impaired sperm fusogenic capacity in addition to ASAs. Human sperm penetration assay (SPA), of the hamster oocyte free from zona pellucida, is a sensitive tool that can address such potential impairment of sperm binding with the oolemma and fusion into the oocyte as well as sperm head decondensation. Males with poor SPA results benefit from ICSI whereas those with good SPA results can still benefit from conventional IVF.

The present study was therefore conducted to address the therapeutic usefulness of a corticosteroid named prednisolone in the treatment of immunologically infertile men undergoing IVF or ICSI determined by SPA.

Read the detailed description

This prospective study was conducted at the Barz IVF Center for Infertility Treatment and Embryo Research, Erbil, Kurdistan Region, Iraq and the Baghdad University Teaching Hospital of the College of Medicine, University of Baghdad, Baghdad, Iraq between October 2014 and May 2016. In all cases, the wife's ova were inseminated with the husband's semen samples. Identified men with positive ASAs were randomly assigned for treatment with or without prednisolone for three cycles. Infertile men were treated with prednisolone tablet, po, for 21 days of their wife's menstrual cycles. Briefly, the prednisolone regimen was started with a dose of 5mg, tid, for two weeks followed by 5mg bid for five days. This was further tapered to one tablet of 5mg/day for two days. Patients were then given one week of rest from the treatment, before this prednisolone regimen was repeated for another two cycles

Treated men that recovered from ASAs and control patients underwent SPA. Patients with positive or negative SPA results were then admitted to conventional IVF or ICSI cycles, respectively. Only the first embryo transfer cycle following IVF or ICSI was included in this analysis.

Being tested
Prednisolone treatment
Keywords
prednisolone, anti-sperm antibodies, sperm penetration assay
Medical subject headings
Infertility

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Prednisolone treatmentDrug

    Also called Experimental

    Infertile men were treated with prednisolone tablet, which is an intermediate acting corticosteroid, po, for 21 days of their wife's menstrual cycles. Briefly, the prednisolone regimen was started with a dose of 5mg, tid, for two weeks followed by 5mg bid for five days. This was further tapered to one tablet of 5mg/day for two days. Patients were then given one week of rest from the treatment, before this prednisolone regimen was repeated for another two cycles.

Study groups in NCT02935738
Study groupRoleWhat they receive
Prednisolone treated men / positive SPA / IVFExperimentalInfertile men, with anti-sperm antibodies, were treated with prednisolone tablet, which is an intermediate acting corticosteroid, po, for 21 days of their wife's menstrual cycles. Briefly, the prednisolone regimen was started with a dose of 5mg, tid, for two weeks followed by 5mg bid for five days. This was further tapered to one tablet of 5mg/day for two days. Patients were then given one week of rest from the treatment, before this prednisolone regimen was repeated for another two cycles. Prednisolone treated men, who recovered from anti-sperm antibodies, underwent then sperm penetration assay (SPA) using zona-free hamster ova. Couples with male partners having positive SPA results (greater than five) were admitted to conventional in vitro fertilization (IVF) cycles.
Receives: Drug: Prednisolone treatment
Prednisolone treated men / negative SPA / ICSIExperimentalInfertile men, with anti-sperm antibodies, were treated with prednisolone tablet, which is an intermediate acting corticosteroid, po, for 21 days of their wife's menstrual cycles. Briefly, the prednisolone regimen was started with a dose of 5mg, tid, for two weeks followed by 5mg bid for five days. This was further tapered to one tablet of 5mg/day for two days. Patients were then given one week of rest from the treatment, before this prednisolone regimen was repeated for another two cycles. Prednisolone treated men, who recovered from anti-sperm antibodies, underwent then sperm penetration assay (SPA) using zona-free hamster ova. Couples with male partners having negative SPA results (equal or less than five) were admitted to intracytoplasmic sperm injection (ICSI) cycles.
Receives: Drug: Prednisolone treatment
Control men / positive SPA / IVFNo interventionInfertile men with anti-sperm antibodies who were not treated with prednisolone, which is an intermediate acting corticosteroid, underwent sperm penetration assay (SPA) using zona-free hamster ova. Couples with male partners having positive SPA results (more than five) were then admitted to in vitro fertilization (IVF) cycle.
Control men / negative SPA / ICSINo interventionInfertile men with anti-sperm antibodies who were not treated with prednisolone, which is an intermediate acting corticosteroid, underwent sperm penetration assay (SPA) using zona-free hamster ova. Couples with male partners having negative SPA results (equal or less than five) were then admitted to intracytoplasmic sperm injection (ICSI) cycles.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Control and Treated Participants With Successful Live Births Following Conventional IVF or ICSI Cycles

    Live birth rates in treated and control patients undergoing conventional IVF or ICSI cycles as determined by the sperm penetration assay (SPA) of hamster zone free ova

    Measured: Nine months (pregnancy term) after the in vitro fertilization.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Oct 2016 (estimated)
  2. Study startOct 2014
  3. Primary completionMar 2016
  4. Study completionMay 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
241 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02935738
Sponsor's protocol ID
Prednisolone-SPA-IVF
Status last verified
Oct 2020
First submitted
11 Oct 2016
Last updated
16 Nov 2020
Data monitoring committee
Yes
Individual data sharing
Undecided

Publications

  • Omu AE, al-Qattan F, Abdul Hamada B. Effect of low dose continuous corticosteroid therapy in men with antisperm antibodies on spermatozoal quality and conception rate. Eur J Obstet Gynecol Reprod Biol. 1996 Nov;69(2):129-34. doi: 10.1016/0301-2115(95)02539-1.

    PubMed 8902446
  • Hendry WF, Treehuba K, Hughes L, Stedronska J, Parslow JM, Wass JA, Besser GM. Cyclic prednisolone therapy for male infertility associated with autoantibodies to spermatozoa. Fertil Steril. 1986 Feb;45(2):249-54. doi: 10.1016/s0015-0282(16)49163-6.

    PubMed 3949025
  • Hendry WF, Hughes L, Scammell G, Pryor JP, Hargreave TB. Comparison of prednisolone and placebo in subfertile men with antibodies to spermatozoa. Lancet. 1990 Jan 13;335(8681):85-8. doi: 10.1016/0140-6736(90)90548-j.

    PubMed 1967425
  • Keane D, Jenkins DM, Higgins T, O'Neill M, Mulcahy MF, Ferriss JB. The effect of intermittent steroid therapy on anti-sperm antibody levels. Eur J Obstet Gynecol Reprod Biol. 1995 Nov;63(1):75-9. doi: 10.1016/0301-2115(95)02217-u.

    PubMed 8674571
  • Bals-Pratsch M, Doren M, Karbowski B, Schneider HP, Nieschlag E. Cyclic corticosteroid immunosuppression is unsuccessful in the treatment of sperm antibody-related male infertility: a controlled study. Hum Reprod. 1992 Jan;7(1):99-104. doi: 10.1093/oxfordjournals.humrep.a137568.

    PubMed 1551969
  • De Almeida M, Feneux D, Rigaud C, Jouannet P. Steroid therapy for male infertility associated with antisperm antibodies. Results of a small randomized clinical trial. Int J Androl. 1985 Apr;8(2):111-7. doi: 10.1111/j.1365-2605.1985.tb00824.x.

    PubMed 3894245
  • Haas GG Jr, Manganiello P. A double-blind, placebo-controlled study of the use of methylprednisolone in infertile men with sperm-associated immunoglobulins. Fertil Steril. 1987 Feb;47(2):295-301.

    PubMed 3545909
  • Vazquez-Levin MH, Notrica JA, Polak de Fried E. Male immunologic infertility: sperm performance on in vitro fertilization. Fertil Steril. 1997 Oct;68(4):675-81. doi: 10.1016/s0015-0282(97)00255-0.

    PubMed 9341610
  • Ayvaliotis B, Bronson R, Rosenfeld D, Cooper G. Conception rates in couples where autoimmunity to sperm is detected. Fertil Steril. 1985 May;43(5):739-42. doi: 10.1016/s0015-0282(16)48557-2.

    PubMed 3996618
  • Pagidas K, Hemmings R, Falcone T, Miron P. The effect of antisperm autoantibodies in male or female partners undergoing in vitro fertilization-embryo transfer. Fertil Steril. 1994 Aug;62(2):363-9. doi: 10.1016/s0015-0282(16)56892-7.

    PubMed 8034086
  • Zini A, Lefebvre J, Kornitzer G, Bissonnette F, Kadoch IJ, Dean N, Phillips S. Anti-sperm antibody levels are not related to fertilization or pregnancy rates after IVF or IVF/ICSI. J Reprod Immunol. 2011 Jan;88(1):80-4. doi: 10.1016/j.jri.2010.09.002. Epub 2010 Dec 15.

    PubMed 21111486
  • Zini A, Fahmy N, Belzile E, Ciampi A, Al-Hathal N, Kotb A. Antisperm antibodies are not associated with pregnancy rates after IVF and ICSI: systematic review and meta-analysis. Hum Reprod. 2011 Jun;26(6):1288-95. doi: 10.1093/humrep/der074. Epub 2011 Mar 23.

    PubMed 21429953
  • Lahteenmaki A, Reima I, Hovatta O. Treatment of severe male immunological infertility by intracytoplasmic sperm injection. Hum Reprod. 1995 Nov;10(11):2824-8. doi: 10.1093/oxfordjournals.humrep.a135800.

    PubMed 8747025
  • Robinson JN, Forman RG, Nicholson SC, Maciocia LR, Barlow DH. A comparison of intrauterine insemination in superovulated cycles to intercourse in couples where the male is receiving steroids for the treatment of autoimmune infertility. Fertil Steril. 1995 Jun;63(6):1260-6. doi: 10.1016/s0015-0282(16)57608-0.

    PubMed 7750598

Questions about this trial

What is this clinical trial studying?

A study testing Prednisolone treatment in people with Reproductive Sterility, run by Barz IVF Center for Infertility Treatment and Embryo Research.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 16 Nov 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Control and Treated Participants With Successful Live Births Following Conventional IVF or ICSI Cycles (time frame: Nine months (pregnancy term) after the in vitro fertilization.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02935738, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Nov 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in