低剂量阿司匹林在体外受精-胚胎移植/卵胞浆内单精子注射周期中的作用

Effect of low-dose aspirin therapy in women undergoing in-vitro fertilization cycles or intracytoplasmic sperm injection cycles

目的探讨阿司匹林对体外受精-胚胎移植/卵胞浆内单精子注射(IVF/ICSI)周期结局的影响。方法在本生殖中心IVF/ICSI周期中行常规长方案降调治疗患者共1,264个周期,采用前瞻性随机法,分为服用阿司匹林(实验组)684周期,未服用阿司匹林(对照组)580周期。实验组于前一周期黄体高峰期用促性腺激素释放激动剂(GnRHa)时加服阿司匹林(75 mg/d),于移植后14 d查血人绒毛膜促性腺激素(hCG)升高即停药。比较两组子宫内膜厚度、超促排卵及妊娠结果。结果实验组子宫内膜厚度(11.26±2.39)mm高于对照组(9.94±2.28)mm(P<0.05),但无明显临床意义。前者临床妊娠率(41%)高于后者(37%),但无显著性差异。余各项指标两组间均无明显差异(P>0.05)。结论在超促排卵过程中,加服阿司匹林,对获卵数,胚胎质量等无显著影响。虽可增加子宫内膜厚度,但临床意义不大。

Objective： To determine the effect of low-dose aspirin on endometrial reception, ovarian response, and pregnancy rates in patients undergoing in-vitro fertilization （IVF） cycles or intracytoplasmic sperm injection （ICSI） cycles. Methods： A total of 1,264 long protocol cycles, from May 2006 to April 2007, were randomized to receive 75 mg of aspirin （n=684） or received no treatment （n=580） daily. Treatment was started on the first day of controlled ovarian stimulation. It was continued until menstruation or a negative pregnancy test. The main outcome measures were the thickness of endometrium, the number of oocytes, number and quality of embryos, the clinical pregnancy rate （PR）. Results. The endometrial thickness in the aspirin group was significantly thicker than that of nontreated group （P〈0.05）, but there was no significant difference in clinic. Clinical PR was higher in the aspirin group （41%） than that of non-treatment group（37%）, but there was no statistically significant difference. The outcome of ovarian responses, such as the mean number of oocytes, the total mean number of embryos, did not differ in groups. Conclusions： Low-dose aspirin has no effect on the number of oocytes, the quality of embryos. Maybe low-dose aspirin can improve the thickness of endometrium, and have any beneficial effect on clinical PR, which has no significance in clinic.