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低强度激光疗法改善反复种植失败患者体外受精结局的随机临床试验

Low-Level Laser Therapy for Improvement of In Vitro Fertilization Outcomes in Patients with Recurrent Implantation Failure: A Randomized Clinical Trial.

作者信息

Jafarabadi Mina, Farbod Yasaman, Shariat Mamak

机构信息

Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Lasers Med Sci. 2024 Jun 5;15:e15. doi: 10.34172/jlms.2024.15. eCollection 2024.

Abstract

Numerous strategies have been investigated for addressing recurrent implantation failure (RIF) and enhancing endometrial receptivity, yet agreement on the optimal intervention remains elusive. Our investigation endeavors to assess the effect of low-level laser therapy (LLLT) on pregnancy outcomes in individuals who have undergone a minimum of three unsuccessful embryo transfer cycles (ET). In our randomized single-blinded clinical trial, we enrolled thirty females with a medical history of RIF who were eligible for frozen-thawed embryo transfer (FET). Through a random allocation sequence, the participants were divided into two groups. The LLLT was performed one cycle before blastocyst transfer in 15 cases using a New Age BIOLASER device (New Age Co., Italy) with a 900-milliwatt power output and an 850-nm wavelength. The irradiation sessions were conducted transabdominal on the hypogastric area. The considered outcomes were biochemical pregnancy, identified by a positive blood pregnancy test, and clinical pregnancy, confirmed through visualization of the gestational sac using ultrasonography. The mean age of the subjects was 34.17 years, and they had undergone three to seven previous embryo transfers. There was no significant difference in basic characteristics between the group undergoing laser treatment and the control group. However, the laser-treated group exhibited elevated rates of both biochemical and clinical pregnancies compared to the control group (46.7% vs. 33.3%; ==0.710 and 33.3% vs. 20.0%; =0.682 respectively). To our knowledge, this study represents the first single-blinded randomized clinical trial to assess the effectiveness of LLLT pretreatment in individuals with RIF. The findings propose that LLLT may potentially enhance biochemical and clinical pregnancy rates among RIF patients.

摘要

为解决反复种植失败(RIF)问题并提高子宫内膜容受性,人们已经研究了许多策略,但对于最佳干预措施仍未达成共识。我们的研究旨在评估低强度激光疗法(LLLT)对至少经历过三次胚胎移植周期(ET)失败的个体妊娠结局的影响。在我们的随机单盲临床试验中,我们招募了30名有RIF病史且符合冻融胚胎移植(FET)条件的女性。通过随机分配序列,将参与者分为两组。15例患者在囊胚移植前一个周期使用意大利New Age公司生产的功率输出为900毫瓦、波长为850纳米的New Age BIOLASER设备进行LLLT。照射部位为下腹部经腹照射。观察的结局指标为血妊娠试验阳性确定的生化妊娠以及通过超声检查妊娠囊可视化确认的临床妊娠。受试者的平均年龄为34.17岁,她们之前进行过三至七次胚胎移植。接受激光治疗的组与对照组在基本特征上无显著差异。然而,与对照组相比,激光治疗组的生化妊娠率和临床妊娠率均有所提高(分别为46.7%对33.3%;P = 0.710和33.3%对20.0%;P = 0.682)。据我们所知,本研究是第一项评估LLLT预处理对RIF个体有效性的单盲随机临床试验。研究结果表明,LLLT可能会提高RIF患者的生化妊娠率和临床妊娠率。

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本文引用的文献

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J Lasers Med Sci. 2023 Aug 29;14:e28. doi: 10.34172/jlms.2023.28. eCollection 2023.
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Cochrane Database Syst Rev. 2021 Jun 10;6(6):CD009517. doi: 10.1002/14651858.CD009517.pub4.
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Gynecol Endocrinol. 2020 Aug;36(8):734-738. doi: 10.1080/09513590.2020.1712694. Epub 2020 Jan 13.
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