Ng Kelvin Kl, Rozen Genia, Stewart Tanya, Agresta Franca, Polyakov Alex
Melbourne Medical School, University of Melbourne Department of Reproductive Services, Royal Women's Hospital, Parkville Melbourne IVF, East Melbourne, Victoria, Australia.
Medicine (Baltimore). 2017 Dec;96(51):e9194. doi: 10.1097/MD.0000000000009194.
Implantation failure is the main factor affecting the success rate of in vitro fertilization (IVF) procedures. Studies have reported that uterine contractions (UCs) at the time of embryo transfer (ET) were inversely related to implantation and pregnancy rate, hence reducing the success of IVF treatment. Various pharmacological agents, with the exception of calcium channel blocker (CCB), have been investigated to reduce UC. In this regard, we are presenting a proposal for a double-blind randomized placebo-controlled trial. The trial aims to determine whether nifedipine, a CCB with potent smooth muscle relaxing activity and an excellent safety profile, can improve the outcome of ET.
We will recruit 100 infertile women into one of 2 groups: placebo (n = 50) and nifedipine 20 mg (n = 50). Study participants will be admitted 30 minutes prior to ET and given either tablet after their baseline vital signs have been recorded. They will then undergo ET and be observed for adverse events for another 30 minutes post-ET. The primary outcome will be implantation rate and clinical pregnancy rate. Secondary outcomes include adverse events, miscarriage and pregnancy, and neonatal outcomes. Resulting data will then be analyzed using t test, Chi-square test, and multivariate test to compare outcomes between the 2 groups for any statistical significance. This protocol has been designed in accordance with the SPIRIT 2013 Guidelines.
着床失败是影响体外受精(IVF)成功率的主要因素。研究报告称,胚胎移植(ET)时的子宫收缩(UCs)与着床率和妊娠率呈负相关,从而降低了IVF治疗的成功率。除钙通道阻滞剂(CCB)外,已对多种药物进行了研究以减少子宫收缩。在这方面,我们提出一项双盲随机安慰剂对照试验的方案。该试验旨在确定硝苯地平,一种具有强大平滑肌舒张活性且安全性良好的CCB,是否能改善胚胎移植的结果。
我们将招募100名不孕妇女,分为两组:安慰剂组(n = 50)和硝苯地平20毫克组(n = 50)。研究参与者将在胚胎移植前30分钟入院,在记录其基线生命体征后给予片剂。然后他们将接受胚胎移植,并在移植后再观察30分钟以观察不良事件。主要结局将是着床率和临床妊娠率。次要结局包括不良事件、流产与妊娠以及新生儿结局。然后将使用t检验、卡方检验和多变量检验对所得数据进行分析,以比较两组之间的结局有无统计学意义。本方案已按照2013年SPIRIT指南设计。