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多囊卵巢综合征患者行体外成熟与标准体外受精治疗后活产的比较:一项非劣效性随机临床试验方案。

Live birth after in vitro maturation versus standard in vitro fertilisation for women with polycystic ovary syndrome: protocol for a non-inferiority randomised clinical trial.

机构信息

Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.

出版信息

BMJ Open. 2020 Apr 14;10(4):e035334. doi: 10.1136/bmjopen-2019-035334.

Abstract

INTRODUCTION

Polycystic ovary syndrome (PCOS) is the first common cause of anovulatory infertility. Currently, in vitro fertilisation (IVF) is recommended when conventional attempts have failed. In vitro maturation (IVM) of human oocytes is an emerging treatment option in infertile women with PCOS. It is a patient-friendly intervention, avoiding the risk of ovarian hyperstimulation syndrome, which is a serious complication of controlled ovarian stimulation in the standard IVF procedure. We plan a randomised controlled trial (RCT) to evaluate whether IVM is non-inferior to the standard IVF for live birth in women with PCOS.

METHODS AND ANALYSIS

This is a single-centre, open-label, non-inferiority RCT performed in a large reproductive medicine centre in China. Infertile women with PCOS will be randomised to receive either IVM or standard IVF in a 1:1 treatment ratio after informed consent. IVF procedures used in our study are all standard treatments and other standard-assisted reproductive technologies will be similar between the two groups. The primary outcome is ongoing pregnancy leading to live birth within 6 months of the first oocyte retrieval cycle after randomisation. Pregnancy outcome, maternal safety and obstetric and perinatal complications will be secondary outcomes. The planned sample size is 350 (175 per group).

ETHICS AND DISSEMINATION

Ethical permission was acquired from the Ethics Committee of Peking University Third Hospital. The results will be issued to publications through scientific journals and conference reports.

TRIAL REGISTRATION NUMBER

NCT03463772.

摘要

简介

多囊卵巢综合征(PCOS)是排卵障碍性不孕的首要常见病因。目前,当常规方法治疗失败时,建议采用体外受精(IVF)。体外成熟(IVM)是人卵在 PCOS 不孕患者中新兴的治疗选择。它是一种对患者友好的干预措施,可以避免卵巢过度刺激综合征的风险,而卵巢过度刺激综合征是标准 IVF 程序中控制性卵巢刺激的严重并发症。我们计划进行一项随机对照试验(RCT),以评估 IVM 是否与 PCOS 患者的活产标准 IVF 相当。

方法与分析

这是在中国一家大型生殖医学中心进行的单中心、开放标签、非劣效性 RCT。经知情同意后,将 PCOS 不孕患者按 1:1 的治疗比例随机分为 IVM 组或标准 IVF 组。我们研究中使用的 IVF 程序均为标准治疗,两组之间其他标准辅助生殖技术也将相似。主要结局是随机分组后首次取卵周期 6 个月内持续妊娠导致活产。妊娠结局、母婴安全性以及产科和围产期并发症将是次要结局。计划样本量为 350 例(每组 175 例)。

伦理与传播

本研究已获得北京大学第三医院伦理委员会的批准。结果将通过科学期刊和会议报告发布。

试验注册号

NCT03463772。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b0f/7200037/305731fb3112/bmjopen-2019-035334f01.jpg

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