不應(yīng)建議女性在胚胎移植后休息

　　Women should not be advised to rest after embryo transfer

　　體外受精期間胚胎移植后的臥床休息與懷孕成功率降低有關(guān)。

　　在一項包含59,000多名參與者的188項隨機對照試驗的薈萃分析中，英國各地的研究人員分析了旨在提高胚胎移植成功率的臨床干預(yù)措施的安全性和科學(xué)有效性。在其中六項試驗中，實施臥床休息（定義為胚胎移植后休息超過20分鐘）將臨床妊娠率降低了15%。這些數(shù)據(jù)為美國生殖醫(yī)學(xué)學(xué)會發(fā)布的指南提供了支持，該指南不鼓勵這種做法。

　　“這是第一項全面概述為接受體外受精的夫婦提供的所有干預(yù)措施的研究，以幫助我們確定進行胚胎移植時的最佳做法?！眮碜訳CL婦女健康研究所和UCLH生殖醫(yī)學(xué)部門的主要作者Bassel Al Wattar博士說。

　　在體外受精期間，受精*被轉(zhuǎn)移到子宮中，盡管有經(jīng)驗證據(jù)，但通常會提供許多“附加物”來幫助子宮內(nèi)膜容受性或鼓勵植入。除了臥床休息外，該研究還評估了37種其他臨床干預(yù)措施的有效性，包括藥物輔助、針灸和正念技術(shù)。服用阿托西班（一種促進子宮松弛的藥物）使成功懷孕的機會增加了49%，類似于使用超聲引導(dǎo)進行胚胎移植或?qū)m內(nèi)輸注hCG激素，這提供了27%和23%的改善，分別。

　　然而，該研究的一個主要限制是研究結(jié)果依賴于學(xué)術(shù)上可用的數(shù)據(jù)，這通常會導(dǎo)致發(fā)表偏倚效應(yīng)，可能會夸大某些干預(yù)措施的重要性。

　　Al Wattar博士承認(rèn)這一點，他說：“雖然目前的證據(jù)對于這些額外的干預(yù)措施仍然不準(zhǔn)確，但不應(yīng)將它們常規(guī)提供給所有接受體外受精的夫婦，等待進一步研究以評估其有效性和安全性?！贝送猓髡卟还膭钤诰脑O(shè)計的隨機對照試驗之前臨床結(jié)合新的和實驗性技術(shù)，例如子宮內(nèi)膜刮擦。

　　該研究發(fā)表在《人類生殖更新》上。

　　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.