Ignite Creation Date:
2024-05-06 @ 3:07 PM
Last Modification Date:
2024-10-26 @ 1:44 PM
Study NCT ID:
NCT04537416
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2024-03-05
First Post:
2020-08-29
Brief Title:
Fertility Hypercoagulability and Inflammation FREYA Registry
Sponsor:
Brigham and Womens Hospital
Organization:
Brigham and Womens Hospital
Study Overview
Official Title:
Multidisciplinary Team-Based Study to Optimize the Evaluation and Treatment of Women With Thrombophilia and Recurrent Pregnancy Loss
Status:
ACTIVE_NOT_RECRUITING
Status Verified Date:
2024-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
FREYA
Brief Summary:
A PubMed search of thrombophilia and infertility yields only 98 articles the majority found in foreign medical journals and subspecialty journals with narrow readerships Outside of Assisted Reproduction Clinics at academic medical centers health care providers have limited awareness of the literature supporting thrombophilia evaluation and treatment in patients with recurrent pregnancy loss As a result women may suffer through years of repeated miscarriages before a thrombophilia evaluation is performed By the time thrombophilia has been diagnosed as the cause of recurrent pregnancy loss couples have often exhausted their personal savings on costly assisted reproductive therapies and present frustrated and psychologically exhausted
In this study we will evaluate the frequency of thrombophilia as a cause of recurrent pregnancy loss and provide insights into our patient care experience at BWH
In this study we will evaluate the frequency of thrombophilia as a cause of recurrent pregnancy loss and provide insights into our patient care experience at BWH
Detailed Description:
Study Design
Over a 2-year period we will perform a retrospective observational cohort analysis of 1000 patients referred to the BWH Center for Infertility and Reproductive Surgery for evaluation of recurrent pregnancy loss This cohort will include a retrospective analysis of 200 infertility patients referred to Dr Piazzas Cardiovascular Medicine clinic for evaluation of thrombophilia
We will also enroll prospectively for 18 months patients referred to the BWH Center for Infertility and Reproductive Surgery for evaluation of recurrent pregnancy loss
Study Population
We will include a study population that is representative of the ethnic and racial diversity of women who receive care at BWH We will not enroll post-menopausal women men or children because recurrent pregnancy loss specifically affects women of child-bearing potential We do not plan to enroll pregnant women because we are specifically focused on women with recurrent pregnancy loss presenting for assisted reproductive therapy
Retrospective Cohort
For our retrospective analysis we will include 800 consecutive women at least 18 years old but not greater than 40 years old with a chief complaint of recurrent pregnancy loss referred to the BWH Center for Infertility and Reproductive Surgery and 200 consecutive patients referred to Dr Piazzas Cardiovascular Medicine clinic for evaluation of thrombophilia as a cause of recurrent pregnancy loss This will provide a total of 1000 patients for the retrospective cohort analysis
Study Inclusion Criteria
1 Age 18-40 years
2 2 or more pregnancy losses including chemical pregnancies but not ectopic pregnancy
3 Evaluated at the BWH Center for Infertility and Reproductive Surgery or the Watkins Cardiovascular Clinic
Study Exclusion Criteria
1 Infertility due to uterine factors such as Ashermans Syndrome
2 Known translocation carrier
3 Prior venous thromboembolism on anticoagulation
4 Abnormal uterine cavity on hysterosalpingogramhysteroscopy
Prospective Cohort
For the 18-month prospective cohort analysis we will enroll consecutive patients evaluated at the BWH Center for Infertility and Reproductive Surgery for recurrent pregnancy loss
Study Inclusion Criteria
1 Age 18-40 years
2 2 or more pregnancy losses including chemical pregnancies but not ectopic pregnancy
3 Evaluated at the BWH Center for Infertility and Reproductive Surgery
Study Exclusion Criteria
1 Infertility due to uterine factors such as Ashermans Syndrome
2 Known translocation carrier
3 Prior venous thromboembolism on anticoagulation
4 Abnormal uterine cavity on hysterosalpingogramhysteroscopy
Study Procedures
From the EPIC Electronic Health Record EHR we will record demographic characteristics comorbid conditions details about the presentation of infertility pregnancy losses and prior assisted reproductive treatments thrombophilia panel results treatments and outcomes including successful pregnancies and deliveries We will calculate the prevalence of thrombophilia in patients referred to BWH Center for Infertility and Reproductive Surgery for evaluation of recurrent pregnancy loss We will describe the outcomes of patients receiving prophylactic low-dose anticoagulation including bleeding thrombotic events and live births We will perform multivariable regression analyses to answer additional key questions of predictors of thrombophilia as a cause of recurrent pregnancy loss and successful treatment of infertility due to thrombophilia
The proposed retrospective and prospective cohort analysis will provide information about the standard of care at BWH for patients with recurrent pregnancy loss who may have thrombophilia The registry will not change the standard of care for diagnosis and treatment of the patients at BWH in any way The registry will not mandate any testing or treatments There will be no required study visits follow-up or subject or provider contact
Data Analysis Plan
We will describe the results of patients receiving prophylactic anticoagulation including frequency of bleeding and thrombotic events We will calculate the prevalence of thrombophilia in patients referred to BWH Center for Infertility and Reproductive Surgery for evaluation of recurrent pregnancy loss We will perform multivariable regression analyses to answer additional key questions of predictors of thrombophilia as a cause of recurrent pregnancy loss chemical pregnancy after assisted reproductive therapy and successful treatment of infertility due to thrombophilia
Over a 2-year period we will perform a retrospective observational cohort analysis of 1000 patients referred to the BWH Center for Infertility and Reproductive Surgery for evaluation of recurrent pregnancy loss This cohort will include a retrospective analysis of 200 infertility patients referred to Dr Piazzas Cardiovascular Medicine clinic for evaluation of thrombophilia
We will also enroll prospectively for 18 months patients referred to the BWH Center for Infertility and Reproductive Surgery for evaluation of recurrent pregnancy loss
Study Population
We will include a study population that is representative of the ethnic and racial diversity of women who receive care at BWH We will not enroll post-menopausal women men or children because recurrent pregnancy loss specifically affects women of child-bearing potential We do not plan to enroll pregnant women because we are specifically focused on women with recurrent pregnancy loss presenting for assisted reproductive therapy
Retrospective Cohort
For our retrospective analysis we will include 800 consecutive women at least 18 years old but not greater than 40 years old with a chief complaint of recurrent pregnancy loss referred to the BWH Center for Infertility and Reproductive Surgery and 200 consecutive patients referred to Dr Piazzas Cardiovascular Medicine clinic for evaluation of thrombophilia as a cause of recurrent pregnancy loss This will provide a total of 1000 patients for the retrospective cohort analysis
Study Inclusion Criteria
1 Age 18-40 years
2 2 or more pregnancy losses including chemical pregnancies but not ectopic pregnancy
3 Evaluated at the BWH Center for Infertility and Reproductive Surgery or the Watkins Cardiovascular Clinic
Study Exclusion Criteria
1 Infertility due to uterine factors such as Ashermans Syndrome
2 Known translocation carrier
3 Prior venous thromboembolism on anticoagulation
4 Abnormal uterine cavity on hysterosalpingogramhysteroscopy
Prospective Cohort
For the 18-month prospective cohort analysis we will enroll consecutive patients evaluated at the BWH Center for Infertility and Reproductive Surgery for recurrent pregnancy loss
Study Inclusion Criteria
1 Age 18-40 years
2 2 or more pregnancy losses including chemical pregnancies but not ectopic pregnancy
3 Evaluated at the BWH Center for Infertility and Reproductive Surgery
Study Exclusion Criteria
1 Infertility due to uterine factors such as Ashermans Syndrome
2 Known translocation carrier
3 Prior venous thromboembolism on anticoagulation
4 Abnormal uterine cavity on hysterosalpingogramhysteroscopy
Study Procedures
From the EPIC Electronic Health Record EHR we will record demographic characteristics comorbid conditions details about the presentation of infertility pregnancy losses and prior assisted reproductive treatments thrombophilia panel results treatments and outcomes including successful pregnancies and deliveries We will calculate the prevalence of thrombophilia in patients referred to BWH Center for Infertility and Reproductive Surgery for evaluation of recurrent pregnancy loss We will describe the outcomes of patients receiving prophylactic low-dose anticoagulation including bleeding thrombotic events and live births We will perform multivariable regression analyses to answer additional key questions of predictors of thrombophilia as a cause of recurrent pregnancy loss and successful treatment of infertility due to thrombophilia
The proposed retrospective and prospective cohort analysis will provide information about the standard of care at BWH for patients with recurrent pregnancy loss who may have thrombophilia The registry will not change the standard of care for diagnosis and treatment of the patients at BWH in any way The registry will not mandate any testing or treatments There will be no required study visits follow-up or subject or provider contact
Data Analysis Plan
We will describe the results of patients receiving prophylactic anticoagulation including frequency of bleeding and thrombotic events We will calculate the prevalence of thrombophilia in patients referred to BWH Center for Infertility and Reproductive Surgery for evaluation of recurrent pregnancy loss We will perform multivariable regression analyses to answer additional key questions of predictors of thrombophilia as a cause of recurrent pregnancy loss chemical pregnancy after assisted reproductive therapy and successful treatment of infertility due to thrombophilia
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None