Sohrabvand Farnaz, Haghollahi Fedyeh, Maasomi Masoomeh, Shariat Mamak
Department of Infertility, Vali-e-Asr Hospital , Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Vali-e-Asr Reproductive Health Research Center, Vali-e-Asr Hospital , Tehran University of Medical Sciences, Tehran, Iran.
Int J Fertil Steril. 2014 Oct;8(3):243-8. Epub 2014 Nov 1.
One of the most important factors affecting success rates in assisted reproductive techniques (ART) besides the number of oocytes retrieved and high quality embryos derived from them is the technical aspects of embryo transfer. It seems that pretreatement with uterine relaxants can be helpful in preventing un- pleasant cramps which can have an adverse effect on ART outcome. In this respect, some drugs such as prostaglandin inhibitors or sedatives have been evaluated but not confirmed yet remain controversial. This study was performed in order to assess the effect of administrating Piroxicam prior to embryo transfer on pregnancy rates in ART cycles.
This pilot study was performed from August 2010 through December 2011 on 50 infertile women in ART cycles. Recombinant follicle stimulating hormone (rFSH) with a long gonadotropin releasing hormone (GnRH) analogue protocol were used for controlled ovarian hyperstimulation. The subjects were randomly allocated into two groups of 25 patients after obtaining written consent. Group A received a 10 mg Piroxicam capsule 30 minutes before embryo transfer and group B was the control group with no treatment. Data were analyzed by Chi-square and analysis of variance (ANOVA).
Pregnancy rate was 34% (n=17) totally, with 32% (n=8) in group A and 36% (n=9) in group B (p=0.75). Uterine cramps were experienced by 4 women (16%) in group B, while none were reported by women in group A (p=0.037).
It seems that Piroxicam administration 30 minutes prior to embryo transfer can- not increase pregnancy rates, but can prevent or reduce uterine cramps after the procedure.
除了获取的卵母细胞数量以及由此获得的高质量胚胎外，影响辅助生殖技术（ART）成功率的最重要因素之一是胚胎移植的技术环节。子宫松弛剂预处理似乎有助于预防不愉快的痉挛，而这种痉挛可能会对ART结局产生不利影响。在这方面，一些药物如前列腺素抑制剂或镇静剂已被评估，但尚未得到证实，仍存在争议。本研究旨在评估胚胎移植前给予吡罗昔康对ART周期妊娠率的影响。
本前瞻性研究于2010年8月至2011年12月对50例处于ART周期的不孕妇女进行。采用重组促卵泡激素（rFSH）联合长效促性腺激素释放激素（GnRH）类似物方案进行控制性卵巢刺激。在获得书面同意后，将受试者随机分为两组，每组25例患者。A组在胚胎移植前30分钟服用10mg吡罗昔康胶囊，B组为对照组，不进行治疗。数据采用卡方检验和方差分析（ANOVA）进行分析。
总妊娠率为34%（n = 17），A组为32%（n = 8），B组为36%（n = 9）（p = 0.75）。B组有4名女性（16%）经历了子宫痉挛，而A组女性均未报告（p = 0.037）。
胚胎移植前30分钟给予吡罗昔康似乎不能提高妊娠率，但可以预防或减少术后子宫痉挛。
