阿托西班在试管婴儿新鲜移植周期中的应用效果分析

目的探讨缩宫素受体拮抗剂阿托西班在体外受精/卵胞质内单精子显微注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)新鲜胚胎移植周期中的应用效果分析。方法选取自2016年1月至2019年12月期间在郑州大学第二附属医院生殖医学部行IVF/ICSI治疗的2349个新鲜取卵移植周期,将符合纳入条件的患者随机分成阿托西班组(1176个周期)和对照组(1173个周期),比较两组的相关指标和妊娠结局。结果阿托西班组的胚胎种植率50.31%(1046/2079)]、临床妊娠率64.37%(757/1176)]、活产率53.17%(553/1040)]明显高于对照组39.09%(817/2090),51.32%(602/1173),41.01%(431/1051)],差异均有统计学意义(P均<0.001)。两组的多胎妊娠率、多胎活产率、异位妊娠率及出生缺陷率比较,差异均无统计学意义(P均>0.05)。阿托西班组的流产率13.47%(102/757)]低于对照组16.45%(99/602)],但差异无统计学意义(P>0.05)。结论阿托西班可以抑制子宫收缩,减少子宫蠕动,提高胚胎种植率、临床妊娠率与活产率,并不增加子代出生缺陷的风险。因此,在IVF/ICSI新鲜移植周期中应用缩宫素受体拮抗剂阿托西班可以有效改善临床结局。

Analysis of the application of atosiban in the fresh embryo transfer cycle in the test-tube baby program

Objective To explore the application of oxytocin receptor antagonist atosiban in the fresh embryo transfer cycle of in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)program.Methods We selected 2349 fresh embryo transfer cycles,ranging from January 2016 to December 2019 in Reproductive Medicine Center,the Second Affiliated Hospital of Zhengzhou University.Patients were randomly categorized into atosiban group(1176 cycles)and control group(1173 cycles).The related indicators and clinical outcomes were compared between the two groups.Results The implantation rate50.31%(1046/2079)],the clinical pregnancy rate64.37%(757/1176)]and the live birth rate53.17%(553/1040)]in atosiban group were remarkably higher than those of control group39.09%(817/2090),51.32%(602/1173),41.01%(431/1051)],and the differences were significant statistically(all P<0.001).There were no differences in multiple pregnancy rate,multiple live birth rate,ectopic pregnancy rate and birth defect rate between the two groups(all P>0.05).Miscarriage rate of atosiban group13.47%(102/757)]was lower than that of control group16.44%(99/602)],but there was no significant difference(P>0.05).Conclusion Atosiban could inhibit uterus contraction and peristalticus to improve implantation rate,clinical pregnancy rate and live birth rate,and atosiban did not increase the risk of birth defect in offspring.Therefore,application of oxytocin receptor antagonist atosiban could improve the clinical outcome in the fresh embryo transfer cycle of IVF/ICSI.