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体外受精-胚胎移植预后良好患者的激光辅助孵化:一项随机对照试验

Laser assisted hatching in good prognosis patients undergoing in vitro fertilization-embryo transfer: a randomized controlled trial.

作者信息

Sagoskin Arthur W, Levy Michael J, Tucker Michael J, Richter Kevin S, Widra Eric A

机构信息

Shady Grove Fertility Reproductive Science Center, Rockville, Maryland 20850, USA.

出版信息

Fertil Steril. 2007 Feb;87(2):283-7. doi: 10.1016/j.fertnstert.2006.07.1498. Epub 2006 Nov 13.

Abstract

OBJECTIVE

To evaluate whether assisted hatching improves clinical outcomes of embryo transfers to good prognosis patients, defined as patients < or =39 years with normal follicle-stimulating hormone (FSH) and E(2) levels, no more than one previous unsuccessful cycle of in vitro fertilization (IVF)-embryo transfer, and good embryo quality.

DESIGN

Prospective randomized controlled trial.

SETTING

Private assisted reproductive technology (ART) center.

PATIENT(S): One hundred ninety-nine good prognosis patients undergoing IVF-embryo transfer.

INTERVENTION(S): In vitro fertilization followed by embryo transfer on day 3 after oocyte retrieval with or without assisted hatching using a 1,480-nm wavelength infrared laser.

MAIN OUTCOME MEASURE(S): Clinical intrauterine pregnancy, spontaneous pregnancy loss, and live birth.

RESULT(S): Rates of clinical intrauterine pregnancy with fetal cardiac activity (53% vs. 54% per cycle), spontaneous pregnancy loss (13% vs. 16% per pregnancy), and live birth (47% vs. 46% per cycle) were very similar between treatment cycles with laser-assisted hatching and control cycles in which embryos were transferred without assisted hatching. There were no significant differences between treatment and control groups in any measured clinical outcome parameters.

CONCLUSION(S): Assisted hatching does not improve clinical outcomes among good prognosis patients.

摘要

目的

评估辅助孵化是否能改善胚胎移植至预后良好患者的临床结局。预后良好患者定义为年龄≤39岁、促卵泡激素(FSH)和雌二醇(E₂)水平正常、既往体外受精-胚胎移植(IVF-ET)周期未超过1次失败且胚胎质量良好的患者。

设计

前瞻性随机对照试验。

地点

私立辅助生殖技术(ART)中心。

患者

199例接受IVF-ET的预后良好患者。

干预措施

取卵后第3天进行体外受精并进行胚胎移植,移植时使用或不使用波长为1480纳米的红外激光进行辅助孵化。

主要观察指标

临床宫内妊娠、自然流产和活产。

结果

激光辅助孵化治疗周期与未进行辅助孵化的胚胎移植对照周期相比,有胎心搏动的临床宫内妊娠率(每个周期分别为53%对54%)、自然流产率(每次妊娠分别为13%对16%)和活产率(每个周期分别为47%对46%)非常相似。治疗组和对照组在任何测量的临床结局参数上均无显著差异。

结论

辅助孵化不能改善预后良好患者的临床结局。

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