自然排卵与在排卵妇女冷胚胎转移之前的编程方案:多中心,随机临床试验
Daimin Wei1,2,3,4, Yingying Qin1,2,3,4,5, Yun Sun6,7
1State Key Laboratory of Reproductive Medicine and Offspring Health, Centre for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University, Jinan 250021, China.
BMJ (Clinical research ed.)
|January 21, 2026
概括
用于冷胚胎移植 (FET) 的自然排卵方案与用于健康活产的编程方案同样有效. 这种方法也显著减少了怀孕期间母亲的并发症,包括先兆子.
科学领域:
- 生殖医学 生殖医学
- 产科和妇科 产科和妇科
- 临床试验 临床试验
背景情况:
- 冷胚胎移植 (FET) 是辅助生殖技术的一个关键组成部分.
- 对于FET的子宫内膜制备方案包括自然排卵和编程方法.
- 优化FET协议对于改善妊娠结果和母亲安全至关重要.
研究的目的:
- 为了比较自然排卵方案的疗效和安全性,与在接受FET的女性进行子宫内膜制备的编程方案相比.
- 评估每种治疗方案对健康活产率和孕产妇并发症 (如子宫前) 的影响.
主要方法:
- 一个多中心的,随机的,平行组的,盲目的临床试验,涉及4376名排卵期妇女接受FET.
- 参与者被分配到自然排卵方案 (监测自然周期) 或编程方案 (激素替代疗法).
- 主要结局包括健康的活产和子宫前/子宫;次要结局包括各种妊娠和新生儿并发症.
主要成果:
- 自然排卵 (41.6%) 和编程 (40.6%) 组之间的健康活产率相似 (RR 1.03,P=0.49).
- 自然排卵组显示出明显降低了子宫前的风险 (2.9%与4.6%,P=0.02),早期怀孕流产,胎盘积分谱,剖腹产和分娩后出血.
- 然而,自然排卵方案的周期取消率较高 (16.2%对11.5%,P<0.001).
结论:
- 在FET中,自然排卵方案用于子宫内膜制备,与健康活产率的规划方案相比,不逊色.
- 自然排卵方法通过减少怀孕期间母亲的并发症提供了显著的好处.
- 虽然周期取消率较高,但改善的母亲安全概况使自然排卵方案成为一个有价值的替代方案.
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