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一项关于激光辅助孵化对高龄女性首次新鲜体外受精-胚胎移植周期结局影响的前瞻性随机对照研究。

A Prospective Randomized Controlled Study of Laser-Assisted Hatching on the Outcome of First Fresh IVF-ET Cycle in Advanced Age Women.

作者信息

Shi Wenhao, Hongwei Tan, Zhang Wei, Li Na, Li Mingzhao, Li Wei, Shi Juanzi

机构信息

Assisted Reproduction Center, Northwest women and children's Hospital, Xi'an, China.

Obstetrics and Gynecology Department, Northwest women and children's Hospital, Xi'an, China.

出版信息

Reprod Sci. 2016 Oct;23(10):1397-401. doi: 10.1177/1933719116641764. Epub 2016 Apr 12.

Abstract

There is no sufficient data to conclude the benefit of assisted hatching (AH) for advanced age patients. However, AH is routinely performed for advanced age patients undergoing in vitro fertilization (IVF) in China based on some retrospective evidence. It is important to assess the benefit of AH procedure for advanced age patients, especially by analyzing the data from China. This is a prospective randomized controlled trial to evaluate the effect of laser AH in the advanced age patients undergoing IVF. A total of 256 patients conformed to the inclusion criteria, and 78 were excluded by exclusion criteria. A total of 178 patients were eligible and randomized to 2 groups (82 AH group and 96 control group). Laser AH (zona thinning) was performed in the AH group. There were no statistical significance in basic clinical parameters between the 2 groups. No difference was found in implantation rate (AH vs control, 32.45% vs 39.29%) and clinical pregnancy rate (AH vs control, 48.78% vs 59.38%). Our data did not find any benefit of laser AH in improving implantation or pregnancy rates in advanced age women. Due to the potential risk and increasing financial burden, AH should not be routinely performed in first fresh IVF embryo transfer cycle for advanced age women.

摘要

目前尚无足够数据得出辅助孵化(AH)对高龄患者有益的结论。然而,基于一些回顾性证据,在中国,接受体外受精(IVF)的高龄患者通常会进行辅助孵化。评估辅助孵化程序对高龄患者的益处非常重要,特别是通过分析来自中国的数据。这是一项前瞻性随机对照试验,旨在评估激光辅助孵化对接受IVF的高龄患者的效果。共有256例患者符合纳入标准,78例因排除标准被排除。共有178例患者符合条件并随机分为两组(82例辅助孵化组和96例对照组)。辅助孵化组进行了激光辅助孵化(透明带变薄)。两组之间的基本临床参数无统计学意义。在种植率(辅助孵化组vs对照组,32.45% vs 39.29%)和临床妊娠率(辅助孵化组vs对照组,48.78% vs 59.38%)方面未发现差异。我们的数据未发现激光辅助孵化对提高高龄女性的种植率或妊娠率有任何益处。由于存在潜在风险和经济负担增加,对于高龄女性的首次新鲜IVF胚胎移植周期,不应常规进行辅助孵化。

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