Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, 100020,, Beijing, People's Republic of China.
Reprod Biol Endocrinol. 2021 Mar 16;19(1):44. doi: 10.1186/s12958-021-00728-x.
A rapid development in assisted reproductive technology (ART) has led to a surge in its popularity among target couples. However, elucidation on the molecular mechanism and effective solutions for a common problem posed by ART, namely transfer failure, is still lacking. The new therapeutic potential of cyclosporin A (CsA), a typical immunosuppressant widely used in the treatment of rejection after organ transplantation, in recurrent pregnancy loss (RPL) patients may inspire some novel transfer failure therapies in the future. To further explore the clinical effects of CsA, this study investigated whether its application can improve clinical pregnancy outcomes in patients with a history of unexplained transfer failure in frozen-thawed embryo transfer (FET) cycles.
Data from a retrospective cohort investigation (178 frozen-thawed embryo transfer cycles in 178 patients) were analysed using binary logistic regression to explore the relationship between CsA treatment and clinical pregnancy outcomes; the odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated as a measure of relevancy. Implantation rate was the main outcome measure.
There was no difference in the fine adjusted OR (95 % CI) of the implantation rate [1.251 (0.739-2.120)], clinical pregnancy rate [1.634 (0.772-3.458)], chemical pregnancy rate [1.402 (0.285-6.909)], take-home baby rate [0.872 (0.423-1.798)], multiple births rate [0.840 (0.197-3.590)], preterm birth [1.668 (0.377-7.373)], abnormal birth weight [1.834 (0.533-6.307)] or sex ratio [0.956 (0.339-2.698)] between the CsA-treated group and control group. No birth defects were observed in the present study.
Although CsA does not affect infant characteristics, it has no beneficial effects on the clinical pregnancy outcomes in patients with a history of unexplained transfer failure in FET cycles.
辅助生殖技术（ART）的快速发展使得其在目标夫妇中越来越受欢迎。然而，对于 ART 带来的一个常见问题，即移植失败，其分子机制和有效解决方案仍有待阐明。环孢素 A（CsA）作为一种广泛用于器官移植后排斥反应治疗的典型免疫抑制剂，在复发性流产（RPL）患者中的新治疗潜力可能为未来的移植失败治疗提供一些新的思路。为了进一步探索 CsA 的临床效果，本研究探讨了 CsA 的应用是否可以改善冷冻-解冻胚胎移植（FET）周期中不明原因移植失败患者的临床妊娠结局。
采用二元逻辑回归分析对回顾性队列研究（178 例患者的 178 个冷冻-解冻胚胎移植周期）的数据进行分析，以探讨 CsA 治疗与临床妊娠结局的关系；计算比值比（OR）及其 95%置信区间（CI）作为相关性的衡量标准。胚胎着床率是主要的结局指标。
CsA 治疗组与对照组之间，胚胎着床率的精细调整 OR（95%CI）[1.251（0.739-2.120）]、临床妊娠率[1.634（0.772-3.458）]、化学妊娠率[1.402（0.285-6.909）]、活产率[0.872（0.423-1.798）]、多胎率[0.840（0.197-3.590）]、早产率[1.668（0.377-7.373）]、出生体重异常率[1.834（0.533-6.307）]和性别比[0.956（0.339-2.698）]差异均无统计学意义。本研究未观察到出生缺陷。
尽管 CsA 不影响婴儿特征，但对 FET 周期中不明原因移植失败患者的临床妊娠结局没有有益影响。
