Clinical adjuncts in in vitro fertilization: a growing list
Clinical adjuncts in in vitro fertilization: a growing list
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DOI：
10.1016/j.fertnstert.2019.09.019
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发表时间：
2019-12-01
影响因子：
6.7
通讯作者：
Sunkara, Sesh Kamal
中科院分区：
文献类型：
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作者：
Kamath, Mohan S.;Mascarenhas, Mariano;Sunkara, Sesh Kamal
在体外受精（IVF）治疗期间，越来越多的临床试验正在使用。大多数这些IVF添加剂（如生长激素，阿司匹林，肝素，脱氢表雄烯二酮，睾酮，男性和女性抗氧化剂和筛查宫腔镜）正在以匆忙的方式引入常规临床实践，在大多数情况下没有任何明确的益处证据。这些附加项目使试管婴儿更加复杂，并增加了治疗的总成本，由夫妇和医疗保健提供者承担。我们目前的审查发现，没有高质量的证据支持在常规实践中使用这些IVF添加剂。必须进行大型、精心设计的随机试验，以评估这些干预措施的有效性和安全性。还迫切需要建立一个以证据为依据的机制，将更新的干预措施引入常规临床环境。(C)2019年，美国生殖医学会。
A growing list of clinical adjuncts are being used during in vitro fertilization (IVF) treatment. Most of these IVF add-ons (such as growth hormone, aspirin, heparin, dehydroepiandrostenedione, testosterone, male and female antioxidants, and screening hysteroscopy) are being introduced into routine clinical practice in a hurried manner without any clear evidence of benefit in most cases. These add-ons make the IVF more complicated and increase the overall cost for the treatment, which is borne by the couples and health care providers. Our current review found no high-quality evidence to support the use of these IVF add-ons in routine practice. Large, well-designed, randomized trials must be conducted to evaluate the effectiveness and safety of these interventions. There is also a pressing need to develop an evidence-dictated mechanism for introducing newer interventions into routine clinical settings. (C) 2019 by American Society for Reproductive Medicine.