胚胎植入前後鴨嘴放鬆施壓於子宮可提高懷孕率

胚胎植入前後鴨嘴放鬆施壓於子宮頸5-7分鐘可防止胚胎排出，
進一步提高懷孕率 (67% vs. 48%)

http://humrep.oxfordjournals.org/content/20/1/170.full

Minimizing embryo expulsion after embryo transfer: a randomized controlled study

1. Ragaa Mansour1

+Author Affiliations

1. The Egyptian IVF-ET Center, 3 Road 161 Hadayek El-Maadi, Cairo 11431, Egypt

1. 1To whom correspondence should be addressed. or Email: ivf@link.net

• Received November 13, 2003.
• Accepted September 29, 2004.

 

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Abstract

BACKGROUND: The aim of this work was to modify the embryo transfer technique to prevent expulsion of the embryos by exerting gentle mechanical pressure on the cervix using the vaginal speculum. METHODS: A total of 639 infertile patients undergoing ICSI were prospectively randomized into two groups using sealed dark envelopes. In the study group (n=325) the screw of the vaginal speculum was loosened in order to exert a gentle pressure on the portiovaginalis of the cervix before ejecting the embryos, and was maintained for 7 min afterwards. In the control group (n=314) no pressure was applied on the cervix during embryo transfer and the vaginal speculum was removed after transferring the embryos. RESULTS: The clinical pregnancy rate was significantly higher in the study group than in the control group [207/325 (67%) versus 150/314 (47.8%); odds ratio (OR) 1.39; 95% confidence interval (CI) 1.11–1.74]. The implantation rate was also significantly higher in the study group [304/913 (33.3%) versus 198/920 (21.5%); OR 1.54; 95% CI 1.26–1.89]. CONCLUSIONS: Applying gentle mechanical pressure on the portiovaginalis of the cervix using the vaginal speculum during and after transferring the embryos significantly improved clinical pregnancy and implantation rates.

鴨嘴放鬆施壓於子宮頸




鴨嘴未放鬆

Table II.

Outcome of treatment

	Study group	Control group	P-value
No. transferred embryos	913	920	(NS) 0.73
Mean±SD per patient	2.91±0.6	2.89±0.69	OR 0.95
			95% CI 0.83–1.04
No good quality embryos (grade I, II)	821	829	(NS) 0.87
Mean±SD per patient (%)	2.16±0.87 (89.92)	2.30±0.87 (90.11)	OR 0.99
			95% CI 0.87–1.14
No. poor quality embryos, (grade III)	92	91	(NS) 0.44
Mean±SD per patient (%)	1.83±1.00 (10.08)	1.87±0.97 (9.89)	OR 1.02
			95% CI 0.75–1.38
Implantation rate (%)	304/913 (33.3)	198/920 (21.5)	0.00002
			OR 1.54
			95% CI 1.26–1.89
Clinical pregnancy rate per transfer (%)	207/325 (67.4)	150/314 (47.8)	0.009
			OR 1.39
			95% CI 1.11–1.74
Multiple pregnancy rate (%)	79/207 (38.2)	38/150 (25.3)	0.09 (NS)
			OR 1.35
			95% CI 0.88–2.07