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Trial registered on ANZCTR
Registration number
ACTRN12623001310651
Ethics application status
Approved
Date submitted
21/09/2023
Date registered
15/12/2023
Date last updated
16/06/2024
Date data sharing statement initially provided
15/12/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Assisted Reproductive Technology in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders (ARTiMS) study. A prospective, longitudinal study.
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Scientific title
Assisted Reproductive Technology use in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders (ARTiMS): A prospective, longitudinal study.
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Secondary ID [1]
310658
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MS200136_0086
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Universal Trial Number (UTN)
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Trial acronym
ARTiMS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pregnancy
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Multiple Sclerosis
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sub-fertility
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Neuromyelitis Optica Spectrum Disorders
332287
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Condition category
Condition code
Neurological
328292
328292
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0
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Multiple sclerosis
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Neurological
328561
328561
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0
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Other neurological disorders
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Reproductive Health and Childbirth
328562
328562
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0
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Fertility including in vitro fertilisation
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Very few studies have investigated the use of Assisted Reproductive Technology (ART) in Multiple Sclerosis (MS) or Neuomyelitis Optica Spectrum Disorders (NMOSD). It is not clear if there is an increase in disease activity after ART, and if there is, whether this is due to hormone treatment, failed cycles or the prolonged cessation of therapy. Additionally, there is currently no guidelines to manage sub-fertility in women with (ww) MS/NMOSD. The decision to cease therapy or not, and the subsequent period of time off treatment is not standardized and is best described as uncoordinated. Determining the key aspects of fertility treatment and MS treatment coordination may assist in developing a pathway for care of this growing cohort of wwMS/NMOSD, as well as provide opportunities to measure and treat hormone level variability and increased stress, anxiety, and depression.
This study will observe women who are planning to use some form of ART to fall pregnant over a three-year period. This will allow for two years to fall pregnant and at least 12 months follow up (into the first trimester post-partum for successful pregnancies.) We will assess blood based biomarkers to determine if there are indicators for both disease activity and pregnancy success.
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Intervention code [1]
327064
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Not applicable
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Comparator / control treatment
no control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The primary outcome is biomarkers of ART cycle success or failure in wwMS/NMOSD using a composite of many factors.
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Assessment method [1]
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1) Demographic, lifestyle and disease information including but not limited to age, body mass index (BMI), smoking status, disease history, treatment use, past environmental exposures and comorbidities as assessed by medical records and study-specific questionnaires.
2) Quality of Life (EQ-5D-5L) questionnaire.
3) Mental health with DASS21 questionnaire.
4) Exercise habits with Godin-Leisure-Time Exercise Questionnaire
5) Sleep habits with the PQSI
6) Serum biomarkers including serum neurofilament light chain, serum Glial fibrillary acidic protein, lymphocyte proportions and activation status assessed by laboratory tests.
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Timepoint [1]
336144
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Baseline
prior to ART cycles (prior to ovarian stimulation and/or embryo transfer if using frozen embryos) (possibly multiple instances)
first trimester (8-14 weeks pregnant)
third trimester (32-36 weeks pregnant)
first trimester post-partum (8-12 weeks post deliver)
miscarriage (optional visit, to occur within 10 days of the miscarriage).
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Secondary outcome [1]
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Identification of composite blood-based biomarkers that can predict relapse rate in wwMS/NMOSD while using ART to fall pregnant
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Assessment method [1]
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1) sNfL
2) sGFAP
3) lymphocyte proportions
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Timepoint [1]
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Baseline
Prior to ART cycles (prior to ovarian stimulation and/or embryo transfer if using frozen embryos) (possibly multiple instances)
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Secondary outcome [2]
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Evaluation of ART use on disease activity (relapse) during ART cycle use, during pregnancy and post-partum.
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Assessment method [2]
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Annualized relapse rate before, during ART use, during pregnancy and after ART use.
Relapses will be determined by accessing the participants medical records (prior to study entry) and assessments that are performed during the trial period.
Before: Assessed by determining the number of relapses (clinical or radiological) recorded in the participants medical record in the 24 months prior to baseline (before ART)
During ART: refers to the period when ART is being used
During pregnancy: From the time pregnancy is confirmed until delivery
Post-partum: 12 months post-partum.
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Timepoint [2]
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Baseline
prior to ART cycles (prior to ovarian stimulation and/or embryo transfer if using frozen embryos) (possibly multiple instances)
first trimester (8-14 weeks pregnant)
third trimester (32-26 weeks pregnant)
first trimester post-partum (8-12 weeks post delivery)
miscarriage (optional, 10 days post miscarriage)
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Eligibility
Key inclusion criteria
Inclusion criteria are women who:
1) Have been diagnosed with MS or NMOSD
2) Who are planning to use ART to fall pregnant within 3 years of study start
3) Who attend one of the 8 MS specialist centres who use MSBase.
4) Who are >18 years of age and <55 years of age
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Minimum age
18
Years
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Maximum age
55
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1) Women who fall pregnant by means other than ART.
2) Male genetic sex
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Study design
Purpose
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
31/01/2024
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Actual
29/04/2024
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Date of last participant enrolment
Anticipated
29/09/2027
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Actual
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Date of last data collection
Anticipated
29/09/2028
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Actual
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Sample size
Target
25
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Accrual to date
1
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,TAS,WA,VIC
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Merck Healthcare Pty. Ltd
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Address [1]
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Building B, Level 1, Suite 1, 11 Talavera Road, Macquarie Park, New South Wales 2113,
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Country [1]
314877
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Australia
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Primary sponsor type
Hospital
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Name
John Hunter Hospital of the Hunter New England Local Health District
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Address
Dept. of Neurology, Lookout Road, New Lambton Heights NSW, 2310, Australia,
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
316875
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Hunter New England Human Research and Ethics Committee
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Ethics committee address [1]
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HMRI building, Level 3, Kookaburra Ct. New Lambton Heights, NSW 2305
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
313875
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07/09/2022
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Approval date [1]
313875
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12/10/2022
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Ethics approval number [1]
313875
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2022ETH/01827
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Summary
Brief summary
Very few studies have investigated the use of Assisted Reproductive Technology (ART), such as in vitro fertilization (IVF), in multiple sclerosis (MS) or Neuromyelitis optica spectrum disorders (NMOSD). This study will provide a comprehensive overview of ART use in women with MS or NMOSD and look at if ART affects disease activity, if MS or NMOSD affects a woman's ability to fall pregnant through ART. Additionally we plan to evaluate blood based tests that might be able to predict both ART success or increased disease activity in women with MS or NMOSD while using ART.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Jeannette Lechner-Scott
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Address
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John Hunter Hospital, Department of Neurology, Lookout Road, New Lambton Heights, NSW 2305
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Country
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Australia
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Phone
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+61 249213540
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Vicki Maltby
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Address
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John Hunter Hospital, Department of Neurology, Lookout Road, New Lambton Heights, NSW, 2305
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Country
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Australia
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Phone
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+61 240420283
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Vicki Maltby
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Address
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John Hunter Hospital, Department of Neurology, Lookout Road, New Lambton Heights, NSW 2305
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Country
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Australia
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Phone
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+61 240420283
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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