PDF(Pubmed)
Abstract：
BACKGROUND: Dysfunctional uterine peristalsis seems to play a pivotal role in hindering embryo implantation among women diagnosed with adenomyosis. This research aims to investigate whether administering an oxytocin receptor antagonist during a frozen embryo transfer (FET) cycle using a hormone replacement therapy (HRT) protocol can enhance in vitro fertilization (IVF) outcomes for infertile women affected by adenomyosis.
METHODS: Between January 2018 and June 2022, our reproductive center conducted IVF-FET HRT cycles for infertile women diagnosed with adenomyosis. Propensity score matching was employed to select matched subjects between the two groups in a 1:1 ratio. Following this, 168 women received an oxytocin receptor antagonist during FET, constituting the study group, while the matched 168 women underwent FET without this antagonist, forming the control group. We conducted comparative analyses of baseline and cycle characteristics between the two groups, along with additional subgroup analyses.
RESULTS: The study group exhibited notably lower rates of early miscarriage compared to the control group, although there were no significant differences in clinical pregnancy rates, ongoing pregnancy rates, and live birth rates between the two groups. Multivariate analysis revealed a negative correlation between the use of oxytocin receptor antagonists and early miscarriage rates in women with adenomyosis. Subgroup analyses, categorized by age, infertility types, and embryo transfer day, showed a substantial decrease in early miscarriage rates within specific subgroups: women aged ≥ 37 years, those with secondary infertility, and individuals undergoing day 3 embryo transfers in the study group compared to the control group. Furthermore, subgroup analysis based on adenomyosis types indicated significantly higher clinical pregnancy rates, ongoing pregnancy rates and live birth rates in the study group compared to the control group among women with diffuse adenomyosis.
CONCLUSIONS: Administering an oxytocin receptor antagonist during FET may reduce the early miscarriage rates in women with adenomyosis.
METHODS: Between January 2018 and June 2022, our reproductive center conducted IVF-FET HRT cycles for infertile women diagnosed with adenomyosis. Propensity score matching was employed to select matched subjects between the two groups in a 1:1 ratio. Following this, 168 women received an oxytocin receptor antagonist during FET, constituting the study group, while the matched 168 women underwent FET without this antagonist, forming the control group. We conducted comparative analyses of baseline and cycle characteristics between the two groups, along with additional subgroup analyses.
RESULTS: The study group exhibited notably lower rates of early miscarriage compared to the control group, although there were no significant differences in clinical pregnancy rates, ongoing pregnancy rates, and live birth rates between the two groups. Multivariate analysis revealed a negative correlation between the use of oxytocin receptor antagonists and early miscarriage rates in women with adenomyosis. Subgroup analyses, categorized by age, infertility types, and embryo transfer day, showed a substantial decrease in early miscarriage rates within specific subgroups: women aged ≥ 37 years, those with secondary infertility, and individuals undergoing day 3 embryo transfers in the study group compared to the control group. Furthermore, subgroup analysis based on adenomyosis types indicated significantly higher clinical pregnancy rates, ongoing pregnancy rates and live birth rates in the study group compared to the control group among women with diffuse adenomyosis.
CONCLUSIONS: Administering an oxytocin receptor antagonist during FET may reduce the early miscarriage rates in women with adenomyosis.
摘要：
背景：在诊断为子宫腺肌病的女性中，功能失调的子宫蠕动似乎在阻碍胚胎植入中起关键作用。这项研究旨在调查在使用激素替代疗法（HRT）方案的冷冻胚胎移植（FET）周期中施用催产素受体拮抗剂是否可以增强受子宫腺肌病影响的不育妇女的体外受精（IVF）结局。
方法：在2018年1月至2022年6月之间，我们的生殖中心对诊断为子宫腺肌病的不孕妇女进行了IVF-FETHRT周期。采用倾向评分匹配以1:1的比例在两组之间选择匹配的受试者。在此之后,168名妇女在FET期间接受了催产素受体拮抗剂，组成研究小组，而匹配的168名女性在没有这种拮抗剂的情况下接受了FET，形成对照组。我们对两组的基线和周期特征进行了比较分析，以及其他亚组分析。
结果：研究组早期流产率明显低于对照组，尽管临床妊娠率没有显着差异，持续怀孕率，两组之间的活产率。多因素分析显示，子宫腺肌病妇女使用催产素受体拮抗剂与早期流产率呈负相关。亚组分析，按年龄分类，不孕症类型，胚胎移植日，在特定亚组中，早期流产率大幅下降：年龄≥37岁的女性，那些患有继发性不孕症的人，与对照组相比，研究组中进行第3天胚胎移植的个体。此外，基于子宫腺肌病类型的亚组分析表明，临床妊娠率明显更高，在弥漫性子宫腺肌病妇女中，研究组的持续妊娠率和活产率与对照组相比。
结论：FET期间给予催产素受体拮抗剂可降低子宫腺肌病女性的早期流产率。
方法：在2018年1月至2022年6月之间，我们的生殖中心对诊断为子宫腺肌病的不孕妇女进行了IVF-FETHRT周期。采用倾向评分匹配以1:1的比例在两组之间选择匹配的受试者。在此之后,168名妇女在FET期间接受了催产素受体拮抗剂，组成研究小组，而匹配的168名女性在没有这种拮抗剂的情况下接受了FET，形成对照组。我们对两组的基线和周期特征进行了比较分析，以及其他亚组分析。
结果：研究组早期流产率明显低于对照组，尽管临床妊娠率没有显着差异，持续怀孕率，两组之间的活产率。多因素分析显示，子宫腺肌病妇女使用催产素受体拮抗剂与早期流产率呈负相关。亚组分析，按年龄分类，不孕症类型，胚胎移植日，在特定亚组中，早期流产率大幅下降：年龄≥37岁的女性，那些患有继发性不孕症的人，与对照组相比，研究组中进行第3天胚胎移植的个体。此外，基于子宫腺肌病类型的亚组分析表明，临床妊娠率明显更高，在弥漫性子宫腺肌病妇女中，研究组的持续妊娠率和活产率与对照组相比。
结论：FET期间给予催产素受体拮抗剂可降低子宫腺肌病女性的早期流产率。
