Blanchet Claudine, Lavallée Élisabeth, Babineau Véronique, Ruchat Stephanie-May
Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC.
Department of Obstetrics and Gynaecology, Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec, University of Montréal, Trois-Rivières, QC.
J Obstet Gynaecol Can. 2018 Mar;40(3):342-350. doi: 10.1016/j.jogc.2017.07.001. Epub 2017 Aug 18.
Physical activity (PA) behaviours after assisted reproductive technology (ART) may influence its success. Bedrest is frequently recommended immediately after intrauterine insemination (IUI) or embryo transfer (ET), and women are also commonly advised to restrict PA after ART. However, these recommendations are not grounded on evidence-based information. The purpose of this systematic review was to assess the impact of PA behaviours during ART on ART success (positive pregnancy test, clinical pregnancy, live birth). A systematic search of the literature was conducted in PubMed, Medline, SPORTdiscus, and CINAHL. The Grading of Recommendations Assessment, Development, and Evaluation system was applied to studies by clinical outcome and used to rate quality of evidence. Twelve studies were included in the review. Our findings suggest that the effect of bedrest immediately after IUI or ET on ART success depends on the procedure used, with favourable effects after IUI ("moderate" quality evidence on clinical pregnancy) but no effect, and even possible unfavourable effects, after ET ("very low" quality evidence on positive pregnancy test and clinical pregnancy). "Very low" quality evidence suggested a decreased live birth rate with bedrest after ET (n = 1) but an increased rate with bedrest after IUI (n = 1). "Very low" quality of evidence suggested no deleterious effect of moderate PA on clinical pregnancy and live birth after ET. On the basis of our findings, studies with more rigourous design and methodology, and considering live birth as an outcome, are needed to provide further evidence on the most appropriate PA behaviours women should adopt to improve ART success.
辅助生殖技术（ART）后的身体活动（PA）行为可能会影响其成功率。宫内人工授精（IUI）或胚胎移植（ET）后通常建议立即卧床休息，并且通常也建议女性在ART后限制身体活动。然而，这些建议并非基于循证信息。本系统评价的目的是评估ART期间PA行为对ART成功率（妊娠试验阳性、临床妊娠、活产）的影响。在PubMed、Medline、SPORTdiscus和CINAHL中对文献进行了系统检索。推荐分级评估、制定和评价系统应用于按临床结局分类的研究，并用于对证据质量进行评级。该评价纳入了12项研究。我们的研究结果表明，IUI或ET后立即卧床休息对ART成功率的影响取决于所采用的程序，IUI后有有利影响（临床妊娠方面为“中等”质量证据），但ET后无影响，甚至可能有不利影响（妊娠试验阳性和临床妊娠方面为“极低”质量证据）。“极低”质量证据表明，ET后卧床休息活产率降低（n = 1），但IUI后卧床休息活产率升高（n = 1）。“极低”质量证据表明，ET后适度身体活动对临床妊娠和活产无有害影响。根据我们的研究结果，需要进行设计和方法更严谨且将活产作为结局的研究，以提供进一步证据，说明女性为提高ART成功率应采取的最适当PA行为。
