Ben-Rafael Z, Ashkenazi J, Shelef M, Farhi J, Voliovitch I, Feldberg D, Orvieto R
Department of Obstetrics and Gynecology Hasharon Hospital Golda Medical Center, Petah Tikya, Israel.
Int J Fertil Menopausal Stud. 1995 Nov-Dec;40(6):303-6.
To evaluate the role of fibrin sealant for embryo transfer (ET) and the effect of patient mobilization after ET on pregnancy rates.
A prospective, randomized, controlled study.
Two hundred eleven patients who were admitted to the IVF Unit over a period of 6 months participated in the study. Patients who had three or more embryos were randomly divided into two groups: group 1 (study group), in which ET was performed using fibrin sealant, and group 2, who served as the controls. Ovulation induction was carried out using the long GnRH-a suppression protocol.
Comparison of the results regarding the implantation and pregnancy rates and ectopic pregnancy rate revealed a nonsignificant difference between the two groups. However, analysis of the results according to the patients' age revealed a significant increase in pregnancy (P < .05) and implantation (P < .01) rate in elderly patients (aged 39-42) using fibrin sealant for ET as compared with controls. Furthermore, we found that bed rest has no advantage over patient mobilization after ET.
The use of fibrin sealant for ET is advantageous in elderly women, but has no apparent effect on the success rate or ectopic pregnancy rate in younger patients. Immediate mobilization does not jeopardize the results of IVF-ET.
评估纤维蛋白封闭剂在胚胎移植(ET)中的作用以及ET后患者活动对妊娠率的影响。
一项前瞻性、随机、对照研究。
6个月内入住体外受精科的211例患者参与了本研究。有三个或更多胚胎的患者被随机分为两组:第1组(研究组),采用纤维蛋白封闭剂进行ET;第2组作为对照组。采用长效促性腺激素释放激素激动剂(GnRH-a)抑制方案进行促排卵。
两组在着床率、妊娠率和异位妊娠率方面的结果比较显示无显著差异。然而,根据患者年龄对结果进行分析发现,与对照组相比,39至42岁的老年患者使用纤维蛋白封闭剂进行ET时,妊娠率(P <.05)和着床率(P <.01)显著提高。此外,我们发现ET后卧床休息并不比患者活动更具优势。
纤维蛋白封闭剂用于ET对老年女性有利,但对年轻患者的成功率或异位妊娠率无明显影响。即刻活动不会危及体外受精-胚胎移植的结果。