生理学的な,ヒアルロナンの選択による細胞内精子注射による不妊治療 (HABSelect):並列の2つのグループによるランダム化試験
David Miller1, Susan Pavitt2, Vinay Sharma3
1Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds Laboratories, University of Leeds, Leeds, UK.
Lancet (London, England)
|February 5, 2019
まとめ
ハイアルロナンの選択を用いた生理学的ICSIは,標準ICSIと比較して生児率を大幅に改善しません. この研究は,PICSIが現在,不妊治療の広範な使用を推奨されていないことを示しています.
科学分野:
- 生殖医学
- 試管受精 に よっ て
- 精子の選択
背景:
- ハイアルロナンの精子選択 (PICSI) は,DNA損傷が少ない精子を選択することで,ICSIの成功率を向上させることを目的としています.
- PICSIは流産率を低下させるかもしれないが,生産率への影響は不明である.
研究 の 目的:
- 標準的なICSIと比較してPICSIの有効性を調査し,不妊治療を受けているカップルの生育率を改善する.
主な方法:
- ランダム化制御された2つのグループによる並行試験で イギリスの16の不妊クリニックで2772のカップルが参加した.
- 夫婦はランダムに (1:1) 新鮮な胚移植でPICSIまたは標準ICSIを受診しました.
- 主な評価項目は,満期生児 (妊娠37週以上) の割合でした.
主要な成果:
- PICSI群 (27. 4%) と標準ICSI群 (25. 2%) の間に生児率の有意な差は認められなかった.
- PICSIとICSIによる生産の確率比は1. 12 (95%CI 0. 951. 34; p=0. 18) であった.
- 重篤な有害事象はグループごとに類似しており,治療に起因するものではありませんでした.
結論:
- PICSIは標準的なICSIと比較して 生産率の有意な改善を提供していません.
- これらの発見に基づいて,現在,不妊治療におけるPICSIのより広範な実施は推奨されていません.
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