Abnormal Uterine Bleeding

Researchers are evaluating the use of inhaled Methoxyflurane, a short-acting and self-administered pain reliever, to improve comfort during intrauterine device IUD insertion. This trial focuses on women aged 18 to 55 undergoing IUD insertion, aiming to assess whether 3 mL of Methoxyflurane can reduce pain and anxiety and improve patient satisfaction compared to a placebo. The study is a double-blind, randomized controlled trial sponsored by Womens College Hospital. Participants are randomly assigned to receive either a Penthrox inhaler with 3 mL of Methoxyflurane or an identical inhaler containing saline as a placebo. Both groups follow a self-inhalation schedule before speculum insertion and may continue as needed during the procedure. Standard pain management is also provided, including recommendations for over-the-counter pain relievers and the option for a cervical block to help reduce discomfort. During the study, participants will be monitored for pain intensity, anxiety, distress, and satisfaction with pain management at various times before, during, and after the procedure, including up to 24 hours later. Researchers will also track any adverse effects or emergency visits. The main outcome is procedural pain intensity measured 20 minutes after the procedure, with additional assessments of patient and provider satisfaction and the effectiveness of blinding. The trial is expected to run until February 2027.

Researchers are collecting real-world data on the Cerene Cryotherapy Device, which was approved by the FDA in 2019 for treating heavy menstrual bleeding in premenopausal women who have completed childbearing. This observational study aims to compare outcomes from routine clinical use of the Cerene device with results from previous pivotal studies, helping to understand its effectiveness and safety in everyday practice. Participants in this registry will have received treatment with the Cerene device as part of their standard medical care. The study does not involve any additional active interventions beyond this treatment. Data collection includes patient and physician surveys covering demographics, quality of life, procedural details, and clinical outcomes following the Cerene treatment. Women will participate for about 13 months, starting from enrollment and continuing through a 12-month follow-up after treatment. During this time, surveys will be completed at multiple points to assess re-intervention rates, quality of life, site of service, physician feedback, and cost analysis. The study concludes after the last participant completes her one-year follow-up visit.

Researchers are observing people with hemophilia A, a genetic bleeding disorder caused by a lack of clotting factor 8 FVIII, who use the drug damoctocog alfa pegol as prescribed by their doctors. The study aims to learn more about the safety of this drug in Korean participants who have previously used other hemophilia A treatments. Hemophilia A can cause excessive bleeding after injury or surgery, and damoctocog alfa pegol replaces the missing FVIII to help prevent or treat bleeding episodes. Participants will continue their usual treatment with damoctocog alfa pegol during routine medical care, following approved product guidelines. No study drug is provided by the researchers, and no changes to healthcare are made for study purposes. Data collection occurs over about 8 months for each participant, from December 2023 to March 2026, with information gathered from health records and routine clinic visits. Participants are involved through their regular medical visits, with no extra tests or visits required for the study. Researchers will monitor and collect data on any medical problems, including various types of adverse events and reactions, during treatment. They will also track bleeding episodes and treatment use, comparing with previous FVIII products. Safety data will be collected continuously during the 36-week observational period without interfering with standard care.

Researchers are evaluating the safety, tolerability, pharmacokinetics, and preliminary anti-tumor activity of a novel oral drug called NKT3964 in adults with advanced or metastatic solid tumors. The study aims to find the recommended dose for further testing and to observe how the drug affects various types of advanced cancers, including ovarian, endometrial, gastric, lung, and breast cancers, particularly those with specific genetic markers like CCNE1 amplification. The study has two main phases Dose Escalation and Dose Expansion. In the Dose Escalation phase, participants receive increasing doses of NKT3964 to assess safety, side effects, and appropriate dosing. The Dose Expansion phase uses the recommended dose from the first phase to further evaluate the drugs anti-tumor activity in specific tumor types. Both phases involve oral administration of the study drug, with detailed criteria for patient eligibility based on cancer type, prior treatments, and genetic markers. Participants will undergo regular assessments including physical exams, laboratory tests, imaging scans, and tumor biopsies before and during treatment. Researchers will monitor drug levels in the blood, treatment side effects, and tumor responses using standard criteria over periods ranging from one month to two years. The study also tracks progression-free survival, overall survival, and other measures to understand the drugs impact and safety profile. Participation involves ongoing monitoring and follow-up visits throughout the study duration.

Researchers are investigating the role of immune factors in infertile women diagnosed with adenomyosis, a condition where endometrial tissue grows into the muscular wall of the uterus. This observational study aims to understand how immune cells and molecules in the blood may affect infertility associated with adenomyosis and to find potential targets for clinical intervention to improve pregnancy outcomes. The study is sponsored by Peking University Third Hospital and follows patients undergoing in vitro fertilization-embryo transfer IVF-ET. Participants include women aged 18 to 40 with regular menstrual cycles who have adenomyosis diagnosed by specific ultrasound criteria. The study involves collecting peripheral blood on the day of embryo transfer, and if pregnancy is confirmed at 14 days, further blood samples are collected at 21 days and every two weeks thereafter until 12 weeks of gestation. Clinical information such as age, body mass index, infertility details, hormone levels, uterine volume, and embryo transfer characteristics are also recorded. Throughout the study, researchers monitor pregnancy outcomes including clinical pregnancy rate within 10 weeks after embryo transfer, miscarriage rate within 24 weeks, and live birth rate within one year. Secondary measures include analysis of immune cells and molecules in the blood during the first 12 weeks of pregnancy. This involves regular follow-up and blood collection to explore immune changes. The total duration of participation varies depending on pregnancy status and follow-up timing.

Uterine fibroids are benign smooth muscle tumors of the uterus that are part of a broader group including malignant tumors with varying severity. Magnetic resonance imaging MRI is commonly used to differentiate fibroids from malignant tumors, but it has limitations that can lead to inappropriate treatment. This study aims to validate a new minimally invasive biopsy technique called ultrasound-guided transuterine vaginal biopsy BVTE to improve preoperative diagnosis and avoid unnecessary or harmful surgeries for uterine smooth muscle tumors. The procedure involves performing the BVTE under general anesthesia on the day scheduled for myomectomy or hysterectomy. The biopsy targets the center of the tumor via a transuterine route to reduce the risk of spreading cancer cells, taking 4 to 5 samples per tumor with a maximum of three tumors sampled. After the biopsy, patients undergo the planned surgery during the same operation, and all surgical specimens are sent for anatomopathological analysis. Participants will be assessed through anatomopathological comparison of the biopsy samples with the reference surgical specimens throughout the study period of 43 months. Researchers will monitor intraoperative and postoperative complications using the Clavien-Dindo classification. This study evaluates the feasibility, safety, and diagnostic accuracy of the BVTE technique as part of current clinical practice for women requiring surgical treatment for uterine smooth muscle tumors.

This research aims to assess the effectiveness and safety of adding oral anticoagulation OAC to background antiplatelet therapy in patients who develop new-onset post-operative atrial fibrillation POAF after isolated coronary artery bypass graft CABG surgery. The study is a prospective, multicenter, open-label, randomized trial comparing OAC with no OAC to evaluate the prevention of thromboembolic events and the risk of major bleeding. Participants are randomly assigned to either an OAC-based strategy using vitamin K antagonists or approved direct oral anticoagulants alongside antiplatelet therapy, or to an antiplatelet-only strategy. The anticoagulation treatment lasts for 90 days, with option for crossover to OAC if recurrent atrial fibrillation occurs after 30 days in the control group. Up to 500 patients may also participate in a digital health substudy using a wearable heart rhythm monitor for 30 days post-discharge. During the study, participants have follow-up visits at 30, 60, 90, and 180 days after randomization, including phone contacts and clinical assessments. Researchers will monitor outcomes such as death, stroke, transient ischemic attacks, myocardial infarction, thromboembolism, and bleeding events up to 180 days. Data from patients who decline randomization are collected in a parallel registry to compare baseline risk and treatment strategies.

Researchers are investigating the effectiveness of two different methods for preparing the uterus lining before frozen embryo transfer in women with adenomyosis undergoing IVF or ICSI. Adenomyosis is a benign condition where tissue normally lining the uterus grows into its muscle, causing infertility and other complications. This randomized clinical trial seeks to determine if combining a GnRH agonist and letrozole with hormone therapy leads to a higher live birth rate compared to hormone therapy alone. Participants are randomly assigned to one of two groups. One group receives pre-treatment with two doses of a GnRH agonist and daily letrozole before starting an artificial cycle with oral estradiol valerate and vaginal progesterone. The other group receives only the artificial cycle hormone treatment without pre-treatment. Embryos are thawed and transferred based on progesterone timing, and hormone support continues through early pregnancy. The trial also evaluates side effects of the pre-treatment and analyzes future babies health and cost-effectiveness. During the study, participants undergo screenings including ultrasound and hormone level tests. Endometrial thickness is monitored, and embryo transfer is performed under ultrasound guidance. Researchers measure outcomes such as live birth rate, pregnancy rates, side effects, pregnancy complications, and newborn health. The study follows participants through pregnancy up to birth and records various fetal and maternal outcomes. Participation lasts from screening through treatment and follow-up until delivery.

Heart failure is a global health issue, and left ventricular assist devices LVADs like the HeartMate 3 are increasingly used to improve survival for patients with advanced heart failure. Despite advances, complications related to blood compatibility, such as clotting and bleeding, remain serious concerns. This trial investigates the safety and effectiveness of using an antithrombotic regimen without aspirin in patients supported by the HeartMate 3 LVAD, building on previous findings that avoiding aspirin may reduce bleeding without increasing clotting risks. The study is a prospective, randomized, controlled trial comparing two treatment groups of advanced heart failure patients who have been supported by the HeartMate 3 LVAD for more than three months. One group will receive warfarin alone, with doses adjusted to maintain a specific blood clotting goal, while the other group will receive warfarin combined with aspirin, which is the current standard of care. Participants will be randomly assigned to one of these two antithrombotic regimens and followed over time to assess outcomes. Participants will be monitored for one year after randomization, with researchers tracking survival free from major hemocompatibility-related events like stroke, pump thrombosis, and significant bleeding. Secondary outcomes such as rates of bleeding, clotting, stroke, rehospitalization, and economic impact will also be evaluated. The study aims to enroll up to 128 patients to ensure sufficient power and includes regular follow-ups to assess safety, treatment adherence, and clinical events.

Researchers are evaluating patient-reported pain, bleeding, and the efficiency of devices used during intrauterine device IUD insertions. This trial compares a new FDA-approved, atraumatic suction cervical stabilizer called Carevix with the standard single-tooth tenaculum, which is considered more traumatic. The study also looks at provider satisfaction and ease of use for these devices, focusing on differences in pain scores between patients who have never given birth nulliparous and those who have multiparous. Participants will be randomly assigned to receive either the Carevix device or the standard tenaculum during their IUD insertion procedure. Providers will perform the procedures using the assigned device, and participants will complete surveys about their pain experience and satisfaction immediately after the procedure. The study collects additional information on cultural background, previous contraceptive use, and reasons for choosing IUD insertion or anticipating removal. During the trial, participants will be evaluated for pain at several points before the procedure, during cervix grasping and traction, at IUD placement, and five minutes after completion. Providers will assess ease of device use, number of placement attempts, bleeding, and overall satisfaction right after the procedure. Patient satisfaction and bleeding cessation time will also be measured. The study runs from March 2026 to March 2027, with ongoing assessments during and immediately after the IUD insertion.