Siristatidis Charalampos, Dafopoulos Konstantinos, Salamalekis George, Galazios George, Christoforidis Nikolaos, Moustakarias Theodoros, Koutlaki Nikoleta, Bouschanetzis Constantinos, Loutradis Dimitrios, Drakakis Petros
a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology , "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece.
b Assisted Reproduction Unit, Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine , University of Thessaly , Larissa , Greece.
Gynecol Endocrinol. 2018 Sep;34(9):747-751. doi: 10.1080/09513590.2018.1442426. Epub 2018 Feb 21.
To compare the effects of the administration of low-molecular-weight heparin (LMWH) in subfertile patients with two or more unsuccessful IVF/ICSI cycles. In this six-center two-arm retrospective cohort study, the study population (230 women) underwent a GnRH-antagonist protocol and was classified into two groups, according to the couse of LMWH or not. Groups were compared regarding the clinical and IVF/ICSI cycle characteristics and reproductive outcomes, whereas clinical pregnancy and miscarriage constituted the primary endpoints. Logistic regression analysis was performed to determine the potential predictors of clinical pregnancy, miscarriage and live birth rates using the Enter method. Baseline characteristics were comparable in the two groups. There was no statistically significant difference between the two study groups with regard neither to clinical pregnancy and miscarriage rates (33/133 vs. 20/97, p = .456 and 15/133 vs. 9/97, p = .624, respectively), nor to the secondary outcomes preset for this study (all p values >.05). Logistic regression revealed that age of the woman and ICSI and dose of gonadotrophins used were predictors of clinical pregnancy and live birth, respectively. In conclusion, there is no evidence to support the standard addition of LMWH in patients with two or more unsuccessful IVF/ICSI cycles.
比较低分子量肝素（LMWH）对两个或更多次体外受精/卵胞浆内单精子注射（IVF/ICSI）周期未成功的亚生育患者的影响。在这项六中心双臂回顾性队列研究中，研究人群（230名女性）接受了促性腺激素释放激素拮抗剂方案，并根据是否使用LMWH分为两组。比较两组的临床及IVF/ICSI周期特征和生殖结局，而临床妊娠和流产作为主要终点。采用逐步回归法进行逻辑回归分析，以确定临床妊娠、流产和活产率的潜在预测因素。两组的基线特征具有可比性。两个研究组在临床妊娠率和流产率方面均无统计学显著差异（分别为33/133 vs. 20/97，p = 0.456和15/133 vs. 9/97，p = 0.624），本研究预设的次要结局也无差异（所有p值>0.05）。逻辑回归显示，女性年龄、ICSI以及促性腺激素使用剂量分别是临床妊娠和活产的预测因素。总之，没有证据支持在两个或更多次IVF/ICSI周期未成功的患者中常规添加LMWH。
