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一项关于激光透明带变薄对高龄女性活产率疗效的随机双盲对照研究。

A randomized double-blind controlled study on the efficacy of laser zona pellucida thinning on live birth rates in cases of advanced female age.

作者信息

Frydman N, Madoux S, Hesters L, Duvernoy C, Feyereisen E, Le Du A, Tachdjian G, Frydman R, Fanchin R

机构信息

Department of Genetic and Reproduction, Hospital Antoine Béclère, Clamart, France.

出版信息

Hum Reprod. 2006 Aug;21(8):2131-5. doi: 10.1093/humrep/del124. Epub 2006 Apr 27.

Abstract

BACKGROUND

It is conceivable that defective embryo hatching plays a part in the mechanisms involved in the decrease of embryo implantation rates with advancing age. In an effort to test this hypothesis, we tested the effectiveness of assisted hatching (AH) in women > or =37 years of age.

METHODS

We prospectively studied 103 IVF-embryo transfer patients undergoing 103 embryo transfers. All of them were > or =37 years of age and had <3 previous IVF-embryo transfer attempts. Laser-AH of transferred embryos was either performed (AH group, n = 49) or not (control group, n = 54) according to randomized and double-blind methodology. Primary outcome was live birth rate.

RESULTS

Population characteristics were comparable in AH and control groups as well as the mean number of embryos transferred (2.7 +/- 0.6 versus 2.7 +/- 0.6) and the prevalence of top quality embryos transferred (65 versus 59%, respectively). We failed to find any statistically significant difference between AH and control groups with regard to implantation (16.1 versus 16.7%, respectively) and live birth rates (22.4 versus 29.6%, respectively).

CONCLUSION

The present study indicates that AH does not improve IVF-embryo transfer outcome in women aged > or =37 years.

摘要

背景

可以想象,胚胎孵化缺陷在随着年龄增长胚胎着床率下降的机制中起一定作用。为了验证这一假设,我们对年龄≥37岁的女性进行了辅助孵化(AH)有效性的测试。

方法

我们前瞻性地研究了103例行体外受精 - 胚胎移植(IVF - ET)的患者,共进行了103次胚胎移植。所有患者年龄≥37岁,且既往IVF - ET尝试次数<3次。根据随机双盲方法,对移植胚胎进行激光辅助孵化(AH组,n = 49)或不进行(对照组,n = 54)。主要结局是活产率。

结果

AH组和对照组的人群特征、移植胚胎的平均数量(分别为2.7±0.6和2.7±0.6)以及优质胚胎移植的比例(分别为65%和59%)具有可比性。我们未发现AH组和对照组在着床率(分别为16.1%和16.7%)和活产率(分别为22.4%和29.6%)方面存在任何统计学上的显著差异。

结论

本研究表明,AH并不能改善年龄≥37岁女性的IVF - ET结局。

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