Talebi Chahvar Solmas, Zosmer Ariel, Caragia Alina, Balestrini Simona, Sabatini Luca, Tranquilli Andrea Luigi, Al-Shawaf Talha
Centre for Reproductive Medicine, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, England, United Kingdom; Department Clinical Sciences, Università Politecnica delle Marche, Via F.Corridoni 11, 60123 Ancona, Italy.
Centre for Reproductive Medicine, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, England, United Kingdom.
Reprod Biomed Online. 2014 Aug;29(2):231-8. doi: 10.1016/j.rbmo.2014.04.014. Epub 2014 May 15.
This study compared the effect on blastocyst development and clinical outcome of coasting in women at increased risk of moderate-severe ovarian hyperstimulation syndrome (OHSS; n=389) with a control group matched for age and basal FSH that did not undergo coasting (n=386) in IVF/intracytoplasmic sperm injection (ICSI) cycles. The main outcome measures were rate of blastocyst development and live birth. More cycles progressed to the blastocyst stage in the coasted group (n=169) compared with the control group (n=83; 43.4% versus 21.5%; P<0.001). The biochemical pregnancy, clinical pregnancy and live birth rates were similar (46.5% versus 42.0%; 40.6% versus 37.8%; 31.6% versus 30.1%). The duration of coasting up to 4 days did not affect progression to blastocyst stage. The multivariate model showed that coasting (OR 1.73, P=0.004) and the number of oocytes retrieved (OR 1.17, P=0.001) were positively correlated with blastocyst formation. Coasting, a measure to reduce the risk of OHSS, does not impair blastocyst development or clinical outcome. Coasting should remain an effective measure to prevent OHSS.
本研究比较了在体外受精/卵胞浆内单精子注射（ICSI）周期中，对发生中重度卵巢过度刺激综合征（OHSS）风险增加的女性（n = 389）进行“延缓”处理与未进行“延缓”处理的年龄及基础促卵泡激素水平相匹配的对照组（n = 386），二者对囊胚发育及临床结局的影响。主要观察指标为囊胚发育率和活产率。与对照组（n = 83）相比，“延缓”组（n = 169）有更多周期进展至囊胚阶段（43.4% 对 21.5%；P < 0.001）。生化妊娠率、临床妊娠率和活产率相似（46.5% 对 42.0%；40.6% 对 37.8%；31.6% 对 30.1%）。长达4天的“延缓”持续时间并不影响进展至囊胚阶段。多变量模型显示，“延缓”（比值比1.73，P = 0.004）和获卵数（比值比1.17，P = 0.001）与囊胚形成呈正相关。“延缓”作为一种降低OHSS风险的措施，不会损害囊胚发育或临床结局。“延缓”应仍是预防OHSS的有效措施。
