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按摩疗法可改善接受冷冻周期囊胚移植患者的体外受精结局。

Massage therapy improves in vitro fertilization outcome in patients undergoing blastocyst transfer in a cryo-cycle.

作者信息

Okhowat Jasmin, Murtinger Maximilian, Schuff Maximilian, Wogatzky Johannes, Spitzer Dietmar, Vanderzwalmen Pierre, Wirleitner Barbara, Zech Nicolas Herbert

出版信息

Altern Ther Health Med. 2015 Mar-Apr;21(2):16-22.

Abstract

CONTEXT

Massage therapy is increasingly used to relieve physical and mental discomfort and is suggested as a safe therapeutic modality, without any significant risks or any known side effects. Although a multitude of complementary therapies, such as acupuncture, are applied in reproductive medicine, no information is available with regard to the application of massage as an adjuvant therapy in assisted-reproduction techniques (ARTs).

OBJECTIVES

This study was intended to assess the effectiveness of a deep relaxation (andullation) therapy based on oscillating vibrations when used prior to embryo transfer (ET) in in vitro fertilization (IVF) cryo-cycles.

DESIGN

The research team designed a retrospective, observational study. Participants willing to undergo the massage treatment were allocated to the intervention (andullation) group.

SETTING

The study was performed at the IVF Centers Prof. Zech-Bregenz in Bregenz, Austria.

PARTICIPANTS

A total of 267 IVF patients, with a mean age of 36.3 y, participated in this single-center study.

INTERVENTION

All patients receiving a transfer of vitrified and warmed blastocysts between January and December 2012 were included in the evaluation. Prior to ET, the andullation group received a standardized program of therapy-a 30-min, deep relaxation massage on an oscillating (vibrating) device, whereas the control group did not.

OUTCOME MEASURES

To determine efficacy, the primary outcomes that the study measured were (1) pregnancy rates (PRs), by testing urine and obtaining a positive β-human chorionic gonadotropin (β-hCG); and (2) ongoing, pregnancies (oPR), by observation of fetal heartbeat and birth rates (BR) as well as miscarriage rates. The patients' medical histories and types of infertility as well as the quality of the embryo transfers (ETs) were evaluated.

RESULTS

In patients using the massage therapy prior to ET, significantly higher PRs, oPRs, and BRs were observed compared with the control group-PR: 58.9% vs 41.7%, P<.05; oPR: 53.6% vs 33.2%, P<.01; and BR: 32.0% vs 20.3%, P<.05. No differences were detected among groups for patients' ages, hormonal substitution protocols, endometrium structures and buildups, quality of transferred embryos, or quality of transfers. No adverse effects were noted in the massage group.

CONCLUSIONS

The research team's results suggested that andullation therapy prior to blastocyst transfer in a cryo-cycle improves embryo implantation, most likely due to a reduction in stress (ie, a relaxation effect on patients), a reduction in uterine contractions, and, probably, an enhancement of the blood flow in the abdominal region. These findings provide support for use of andullation as a complementary therapy for ART.

摘要

背景

按摩疗法越来越多地用于缓解身心不适,被认为是一种安全的治疗方式,没有任何重大风险或已知副作用。尽管诸如针灸等多种辅助疗法已应用于生殖医学,但关于按摩作为辅助生殖技术(ART)的辅助疗法的应用尚无相关信息。

目的

本研究旨在评估基于振荡振动的深度放松(安抚)疗法在体外受精(IVF)冷冻周期胚胎移植(ET)前使用时的有效性。

设计

研究团队设计了一项回顾性观察研究。愿意接受按摩治疗的参与者被分配到干预(安抚)组。

地点

该研究在奥地利布雷根茨的泽赫 - 布雷根茨教授IVF中心进行。

参与者

共有267名IVF患者参与了这项单中心研究,平均年龄为36.3岁。

干预

2012年1月至12月间所有接受玻璃化冷冻解冻囊胚移植的患者纳入评估。在胚胎移植前,安抚组接受标准化治疗方案——在振荡(振动)设备上进行30分钟的深度放松按摩,而对照组则不接受。

观察指标

为确定疗效,本研究测量的主要观察指标为:(1)妊娠率(PRs),通过检测尿液并获得β - 人绒毛膜促性腺激素(β - hCG)阳性结果;(2)持续妊娠率(oPR),通过观察胎儿心跳、出生率(BR)以及流产率。评估了患者的病史、不孕类型以及胚胎移植(ET)的质量。

结果

与对照组相比,在胚胎移植前使用按摩疗法的患者中观察到显著更高的妊娠率、持续妊娠率和出生率——妊娠率:58.9% 对41.7%,P <.05;持续妊娠率:53.6% 对33.2%,P <.01;出生率:32.0% 对20.3%,P <.05。在患者年龄、激素替代方案、子宫内膜结构和厚度、移植胚胎质量或移植质量方面,各组之间未检测到差异。按摩组未观察到不良反应。

结论

研究团队的结果表明,在冷冻周期的囊胚移植前进行安抚疗法可提高胚胎着床率,最可能的原因是压力降低(即对患者的放松作用)、子宫收缩减少以及可能腹部区域血流增加。这些发现为使用安抚疗法作为ART的辅助疗法提供了支持。

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