Low-dose aspirin does not improve ovarian responsiveness or pregnancy rate in IVF and ICSI patients:: a randomized, placebo-controlled double-blind study
Low-dose aspirin does not improve ovarian responsiveness or pregnancy rate in IVF and ICSI patients:: a randomized, placebo-controlled double-blind study
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DOI：
10.1093/humrep/dei020
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发表时间：
2005-08-01
影响因子：
6.1
通讯作者：
Martikainen, H
中科院分区：
文献类型：
--
作者：
Päkkilä, M;Räsänen, J;Martikainen, H
背景：在辅助生殖技术中，卵巢和子宫内膜对促性腺激素刺激的不良反应导致妊娠率下降。本研究的目的是验证控制性卵巢刺激前开始使用低剂量阿司匹林可改善卵巢反应性、妊娠率（PR）和妊娠结局的假设。方法：共有374名接受IVF/ICSI的妇女被随机分配接受100 mg阿司匹林（n=186）或安慰剂（n=188）。在控制性卵巢刺激的第一天开始治疗。一直持续到月经或妊娠试验阴性。孕妇继续服药直至分娩。主要结局指标为卵母细胞数量、胚胎数量和质量、临床PR和妊娠结局。研究结果：平均（+/- SD）卵母细胞数（12.0 +/- 7.0 vs 12.7 +/- 7.2），胚胎的总平均数（5.82 +/- 4.35 vs 5.99 +/- 4.66），优质胚胎的平均数量阿司匹林组和安慰剂组的胚胎移植率（0.99 +/- 1.39 vs 1.18 +/- 1.51）和胚胎移植数（1.64 +/- 0.64 vs 1.63 +/- 0.71）没有差异。阿司匹林组和安慰剂组之间，每次胚胎移植的临床PR（25.3%，n=44/174 vs. 27.4%，n=48/175）或每个周期开始的临床PR（23.7% vs. 25.5%）无统计学显著差异。每次胚胎移植的出生率在阿司匹林组（18.4%）和安慰剂组（21.1%）之间没有显著差异。两组的不良反应发生率[12例（6.5%）vs 13例（6.9%）]相似。结论：目前的结果表明，低剂量阿司匹林治疗对接受IVF/ICSI的未选择女性的卵巢反应性、PR和妊娠结局没有任何有益影响。
BACKGROUND: Poor ovarian and endometrial responses to gonadotrophin stimulation in assisted reproduction techniques lead to decreased pregnancy rates. The aim of the present study was to test the hypothesis that low-dose aspirin started prior to controlled ovarian stimulation improves ovarian responsiveness, pregnancy rate (PR) and pregnancy outcome. METHODS: A total of 374 women who were to undergo IVF/ICSI were randomized to receive 100 mg of aspirin (n=186) or placebo (n=188) daily. Treatment was started on the first day of controlled ovarian stimulation. It was continued until menstruation or a negative pregnancy test. Pregnant women continued the medication until delivery. The main outcome measures were the number of oocytes, number and quality of embryos, the clinical PR and pregnancy outcome. RESULTS: The mean (+/- SD) number of oocytes (12.0 +/- 7.0 versus 12.7 +/- 7.2), the total mean number of embryos (5.82 +/- 4.35 versus 5.99 +/- 4.66), the mean number of top quality embryos (0.99 +/- 1.39 versus 1.18 +/- 1.51) and the number of embryos transferred (1.64 +/- 0.64 versus 1.63 +/- 0.71) did not differ in the aspirin and placebo groups. Between the aspirin and placebo group, there was no statistically significant difference in clinical PR per embryo transfer (25.3%, n=44 out of 174 versus 27.4%, n=48 out of 175) or clinical PR per cycle initiated (23.7% versus 25.5%). Birth rate per embryo transfer did not differ significantly between the aspirin (18.4%) and placebo (21.1%) groups. The incidence of poor responders [12 (6.5%) versus 13 (6.9%)] was similar in both groups. CONCLUSIONS: The present results indicate that low-dose aspirin treatment does not have any beneficial effect on ovarian responsiveness, PR and pregnancy outcome in unselected women undergoing IVF/ICSI.