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子宫内膜损伤对首次体外受精/卵胞浆内单精子注射周期结局的影响:一项随机对照试验。

The effect of endometrial injury on first cycle IVF/ICSI outcome: A randomized controlled trial.

作者信息

Mahran Ahmad, Ibrahim Mahmoud, Bahaa Haitham

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.

出版信息

Int J Reprod Biomed. 2016 Mar;14(3):193-8.

Abstract

BACKGROUND

Implantation remains a limiting step in IVF/ICSI. Endometrial injury isa promising procedure aiming at improving the implantation and pregnancy rates after IVF/ICSI.

OBJECTIVE

The aim of this study was to evaluate the effect of endometrial injury induced in precedingcycle on IVF/ICSI outcome.

MATERIALS AND METHODS

Four hundred patients undergoing their first IVF/ICSI cycle in two IVF units in Minia, Egypt were randomly selected to undergo either endometrial injury in luteal phase of preceding cycle (intervention group) or no treatment (control group). Primary outcome wasthe implantation and live birth ratesWhile the secondary outcome was clinical pregnancy, miscarriage, multiple pregnancy rates, pain and bleeding during and after procedure.

RESULTS

Implantation and live birth rates were significantly higher in intervention compared with control group (22.4% vs. 18.7%, p=0.02 and 67% vs. 28%, p=0.03), respectively. There was also a significant reduction in miscarriage rate in intervention group (4.8% vs. 19.7%, respectively, p<0.001).

CONCLUSION

Endometrial injury in preceding cycle improves the implantation rate and live birth rate and reduces the miscarriage rate per clinical pregnancy in patients undergoing their first IVF/ICSI cycle.

摘要

背景

着床仍然是体外受精/卵胞浆内单精子注射(IVF/ICSI)中的一个限制步骤。子宫内膜损伤是一种有前景的方法,旨在提高IVF/ICSI后的着床率和妊娠率。

目的

本研究旨在评估在前一周期诱导的子宫内膜损伤对IVF/ICSI结局的影响。

材料与方法

在埃及米尼亚的两个IVF中心,随机选择400例首次接受IVF/ICSI周期治疗的患者,在前一周期的黄体期进行子宫内膜损伤(干预组)或不进行治疗(对照组)。主要结局是着床率和活产率,次要结局是临床妊娠率、流产率、多胎妊娠率、手术期间及术后的疼痛和出血情况。

结果

干预组的着床率和活产率显著高于对照组(分别为22.4%对18.7%,p = 0.02;67%对28%,p = 0.03)。干预组的流产率也显著降低(分别为4.8%对19.7%,p < 0.001)。

结论

在前一周期进行子宫内膜损伤可提高首次接受IVF/ICSI周期治疗患者的着床率和活产率,并降低每例临床妊娠的流产率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d541/4899760/8519c4e4406b/ijrb-14-193-g001.jpg

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