胚胎植入管比較

二種胚胎植入管之比較
Tom cat 單腔硬式 vs. Cook 7019 雙腔軟式

Cook 7019 雙腔軟式優於TomCat單腔硬式胚胎植入管

http://humrep.oxfordjournals.org/content/17/6/1502.full

A randomized controlled trial of a soft double lumen embryo transfer catheter versus a firm single lumen catheter: significant improvements in pregnancy rates

1. Janelle A. McDonald1,3 and 
2. Robert J. Norman1

+Author Affiliations

1. ¹Suite 14, John James Medical Centre, 175 Strickland Crescent, Deakin, ACT 2600 and
2. ²The Reproductive Medicine Unit, The Queen Elizabeth Hospital and Wakefield Clinic, Department of Obstetrics and Gynaecology, University of Adelaide, Australia

• Received September 20, 2001.
• Accepted January 16, 2002.

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Abstract

BACKGROUND: Embryo transfer has changed little since originally described in 1978. Clinicians rate the type of catheter used as the third most important variable in embryo transfer, but there are no adequately powered randomized trials. We compared the clinical pregnancy rates with the single lumen catheter (TCC) and the double lumen catheter (CC) in a randomized single blind trial. METHODS: A total of 650 cycles of women from the Adelaide University reproductive medicine units in Australia were included in this trial. Patients were <40 years of age undertaking IVF and embryo transfer. Exclusion criteria were: known uterine abnormality, day 3 FSH >10 IU/l, previous difficult embryo transfer and pre-implantation genetic diagnosis. Cycles were randomized from numbered sealed envelopes immediately prior to embryo transfer with stratification for fresh or frozen cycles. RESULTS: There was a significantly higher pregnancy rate in the group treated with the CC compared with the TCC catheter [29.6 versus 20.5% per embryo transfer, odds ratio (OR) = 1.63 (95% confidence interval: 1.14–2.30), P = 0.0076]. The point estimate for the OR was similar for fresh and frozen cycles. CONCLUSIONS: The pregnancy rate was increased by 50% and this justifies the increased cost of the soft double lumen catheter and the training of clinical staff required.

Table III.

Pregnancy rates (%) in randomized controlled trials comparing two or more catheters

	Catheter type
	Firm	Soft	Soft	Soft	Soft	Soft
	(single)	(single)	(double)	(double)	(double)	(double + introducer)
	Tom Cat	TDT	Cook	Frydman	Wallace	Erlanger
McDonald (current study)	67/326 (20.5)		96/324 (29.6)
Wisanto, 1989		9/98 (9.2)		31/96 (32.3)	19/99 (19.2)
Meriano, 2000	16/34 (47)	5/32 (14.7)
Boone, 2001			85/220 (39)		89/209 (43)
Ghazzawi, 1999					31/160 (19)	48/160 (30)
al-Shawaf, 1993				(30.7)	(30.3)