Clinical Trial: Maternal Embryo Interaction in Recurrent Miscarriages

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: The Maternal-embryo Interaction and Its Role in the Etiology of Recurrent Miscarriages

Brief Summary:

Background of the study:

The etiology of recurrent miscarriage (RM, defined as three or more consecutive miscarriages without any proven maternal or fetal cause), remains undiagnosed in more than 50% of cases. In these cases it is generally considered that a disturbance in the normal mother-embryo interactions is a causal factor. This disturbance may be based on a dysregulation of embryo invasiveness and/or decidual acceptance (e.g. altered decidualization; endometrial changes in preparation for the acceptance of a putative pregnancy). Moreover, dysfunctional maternal immune regulatory natural killer (NK) cells, implicated in tolerance induction and trophoblast invasion,may also underlie the occurrence of RM. The Selection Failure hypothesis for RM suggests that super-receptive endometrium (possibly due to increased embryo invasiveness and/or decidual acceptance and/or dysregulated immune cell function) may allow 'poor quality' embryos to implant and present as a clinical pregnancy before miscarrying. Fundamental knowledge on mechanisms of embryo implantation, decidual function and maternal immune reactivity in successful pregnancies has accumulated over the past 5 years. This study aims to investigate whether dysregulation of (one of) these mechanisms may underlie RM.

Objective of the study:

To test The Selection Failure hypothesis by assessing A) the degree of embryo invasiveness and decidual acceptance (the quality of decidualization, endometrium-embryo communication and endometrial stromal cell (ESC) migration) and B) the angiogenic capacity of decidual NK (dNK) cells, in order to elucidate the pattern of the mother-embryo equilibrium in women with RM.


Detailed Summary:
Sponsor: UMC Utrecht

Current Primary Outcome: Embryo survival on decidualized ESCs of RM patients or fertile controls (Embryo survival as an indirect measure of embryo invasiveness) [ Time Frame: 2 years ]

Embryo survival as an indirect measure of embryo invasiveness


Original Primary Outcome: Same as current

Current Secondary Outcome:

Original Secondary Outcome:

Information By: UMC Utrecht

Dates:
Date Received: April 1, 2010
Date Started: June 2010
Date Completion:
Last Updated: May 15, 2017
Last Verified: May 2017