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普得尼松对避孕管切除术逆转结果的影响 (iPRED研究):来自随机对照临床试验的结果
Landon Trost1, Sevann Helo2, Klinton Brearton3
1Male Fertility and Peyronie's Clinic, Orem, Utah; Department of Physiology and Developmental Biology, Brigham Young University, Provo, Utah.
Fertility and sterility
|November 22, 2024
概括
高剂量的普雷尼松 (20毫克) 在输精管切除术逆转后显著降低了怀孕率. 较低剂量 (5 mg) 不会影响怀孕或精子数量,这表明普德尼松的剂量依赖性影响.
科学领域:
- 生殖医学是一种生殖医学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 临床药理学 临床药理学
背景情况:
- 血管切除术逆转的目的是恢复生育能力.
- 精子颗粒瘤的形成可以阻碍成功.
- 普雷德尼松是一种抗炎性皮质类固醇.
研究的目的:
- 评估普得尼松在改善怀孕率和精液度的疗效和安全性.
- 为了确定普得尼松对生殖结果的剂量依赖性影响.
主要方法:
- 一个随机对照试验 (NCT04788823) 涉及男性进行输精管切除术逆转.
- 四个臂:控制,Pred高 (20毫克逐渐),PredPRN (20毫克逐渐,如有需要),和Pred低 (5毫克/日).
- 在1年内测量的结果包括怀孕率,精液度和不良事件.
主要成果:
- 1年后的怀孕率在控制 (65%) 和预测低 (67%) 组比预测高 (17%) 和预测PRN (38%) 组更高.
- 高剂量普得尼松 (20毫克) 组由于怀孕率较低而提前停止使用.
- 两组之间没有观察到精子通透率或度的显著差异.
结论:
- 高剂量普得尼松 (20毫克) 对在输精管切除术逆转后的怀孕率产生负面影响.
- 对怀孕的有害影响取决于剂量,并且独立于精子度.
- 普雷尼松,剂量从5到20毫克,不会影响精子度.
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