阿司匹靈是否有效的改善婦女接受試管嬰兒治療的懷孕率?

 

我們常看到臨床的試管療程用上Aspirin,我自己也開,

 

 

大型匯總式的研究顯示阿司匹靈對試管療程

 

 

不會增加懷孕率。

 

 

出處:第一名的不孕症期刊

 

Hum Reprod Update. 2011 Mar 21.

 

[Epub ahead of print]

 

 

阿司匹靈是否有效的改善婦女接受試管嬰兒的懷孕

 

 

率?果是從個別病人的數據匯總分析

 

 

來自荷蘭的研究

 

 

摘要

 

 

阿司匹靈被認為可能提高試管嬰兒的療效,但以往傳統的分

 

 

析的結果是矛盾的。因此,我們進行了個別病人的數據的臨床

 

 

隨機試驗(RCTs)綜合分析關於這個問題。

 

結論是阿司匹並不能改善試管嬰兒的懷孕率。

 

原文 

Is aspirin effective in women undergoing in vitro fertilization (IVF)? Results from an individual patient data meta-analysis (IPD MA).

 

Groeneveld EBroeze KALambers MJHaapsamo MDirckx KSchoot BCSalle BDuvan CISchats RMol BWHompes PGthe IPD MARIA study group.

 

Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, The Netherlands.

 

Abstract

 

BACKGROUND Aspirin is believed to improve the outcome of IVF, but previous conventional meta-analyses on the subject are conflicting. Therefore, we performed a meta-analysis with individual patient data (IPD MA) of randomized clinical trials (RCTs) on the subject. METHODS A systematic literature search was conducted to identify RCTs assessing the effectiveness of aspirin in IVF. Authors were asked to share their original data. In a one step meta-analytic approach, the treatment effect of aspirin was estimated with odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression, based on the intention to treat principle. RESULTS Ten studies fulfilled the inclusion criteria. Authors of six studies provided IPD, including 1119 patients (562 placebo and 557 aspirin). There were 160 clinical pregnancies in the aspirin (28.8%) and 179 (31.9%) in the placebo group [OR 0.86, 95% CI (0.69-1.1)]. There were 129 ongoing pregnancies in the aspirin (23.6%) and 147 in the placebo group (26.7%) [OR 0.85, 95% CI (0.65-1.1)]. Whereas the conventional meta-analysis limited to studies that could provide IPD showed an OR of 0.89 (95% CI 0.69-1.2), the conventional meta-analysis limited to the eight studies of which method of randomization could be confirmed showed an OR of 0.94 (95% CI 0.76-1.17) and the conventional meta-analysis including all 10 eligible RCTs identified with our search changed the OR to 1.07 (95% CI 0.81-1.41). This difference in direction of effect, derived from the studies not able to share IPD of which quality of randomization could not be confirmed. CONCLUSIONS Aspirin does not improve pregnancy rates after IVF.

 

僅管如此,我相信很多人依舊會抱著至少沒害處,試管嬰兒的療程會繼續使用。



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