| < style="text-align: center;"> 不应建议女性在胚胎移植后休息< style="text-align: center;"> Women should not be advised to rest after embryo transfer 体外受精期间胚胎移植后的卧床休息与怀孕成功率降低有关。 在一项包含59,000多名参与者的188项随机对照试验的荟萃分析中，英国各地的研究人员分析了旨在提高胚胎移植成功率的临床干预措施的安全性和科学有效性。在其中六项试验中，实施卧床休息（定义为胚胎移植后休息超过20分钟）将临床妊娠率降低了15%。这些数据为美国生殖医学学会发布的指南提供了支持，该指南不鼓励这种做法。 “这是一项全面概述为接受体外受精的夫妇提供的所有干预措施的研究，以帮助我们确定进行胚胎移植时的最佳做法。”来自UCL妇女健康研究所和UCLH生殖医学部门的主要作者Bassel Al Wattar博士说。 在体外受精期间，受精卵被转移到子宫中，尽管有经验证据，但通常会提供许多“附加物”来帮助子宫内膜容受性或鼓励植入。除了卧床休息外，该研究还评估了37种其他临床干预措施的有效性，包括药物辅助、针灸和正念技术。服用阿托西班（一种促进子宫松弛的药物）使成功怀孕的机会增加了49%，类似于使用超声引导进行胚胎移植或宫内输注hCG激素，这提供了27%和23%的改善，分别。 然而，该研究的一个主要限制是研究结果依赖于学术上可用的数据，这通常会导致发表偏倚效应，可能会夸大某些干预措施的重要性。 Al Wattar博士承认这一点，他说：“虽然目前的证据对于这些额外的干预措施仍然不准确，但不应将它们常规提供给所有接受体外受精的夫妇，等待进一步研究以评估其有效性和安全性。”此外，作者不鼓励在精心设计的随机对照试验之前临床结合新的和实验性技术，例如子宫内膜刮擦。 该研究发表在《人类生殖更新》上。 原文： Bed rest following embryo transfer during IVF has been linked with reduced pregnancy success. In a meta-analysis of 188 randomised control trials,containing more than 59,000 participants,researchers across the UK analysed the safety and scientific validity of clinical interventions which aim to improve embryo transfer success rates.Across six of these trials,the implementation of bed rest,defined as more than 20 minutes rest following embryo transfer,reduced clinical pregnancy rates by 15 percent.These data provide support for guidelines issued by the American Society for Reproductive Medicine,which discourage this practice. 'This is the first study to present a comprehensive overview of all interventions offered to couples undergoing IVF to help us decide what is the best practice when performing an embryo transfer.'said lead author Dr Bassel Al Wattar from the UCL Institute for Women's Health and UCLH Reproductive Medicine Unit. During IVF,the fertilised egg is transferred into the womb,with many'add-ons'offered to assist endometrial receptivity or to encourage implantation,often despite empirical evidence.In addition to bed rest,the study also assessed the effectiveness of 37 other clinical interventions,including pharmacological assistance,acupuncture,and mindfulness techniques.Administration of Atosiban(a drug that promotes uterine relaxation)increased the chance of a successful pregnancy by 49 percent,similar to using ultrasound guidance for embryo transfer or having an intrauterine infusion of the hCG hormone,which provided a 27 percent and 23 percent improvement,respectively. However,a primary limitation of the study is that the findings rely on academically available data,which often leads to a publication bias effect,potentially inflating the significance of certain interventions. Acknowledging this,Dr Al Wattar stated,'While the current body of evidence remains imprecise for these additional interventions,they should not be offered routinely to all couples undergoing IVF pending further research to evaluate their effectiveness and safety.'Furthermore,the authors discourage the clinical incorporation of new and experimental techniques,such as endometrial scratching,prior to well-designed randomised control trials. The study was published in Human Reproduction Update. |
