Atosiban使42歲試管嬰兒懷孕成功？

Atosiban使42歲試管嬰兒懷孕成功？


http://www.youtube.com/watch?v=-e_iaS0_Bkk






博元婦產科不孕症試管嬰兒中心:蔡鋒博醫師,陳昭雯醫師


什麼安胎藥可以增加試管嬰兒成功率？


Oxytocin antagonists may improve infertility treatment.
Pierzynski P, Reinheimer TM, Kuczynski W.


Center for Reproductive Medicine KRIOBANK, Bialystok, Poland. piotr.pierzynski@wp.pl


Abstract
OBJECTIVE: To confirm the improvement of uterine receptivity following administration of oxytocin and vasopressin V1A antagonist atosiban.


DESIGN: Case report.


SETTING: Private reproductive medicine center.


PATIENT(S): A 42-year-old woman with a history of 15 years' infertility and seven failed in vitro fertilization/embryo transfer (IVF-ET) attempts.


INTERVENTION(S): Atosiban (mixed vasopressin V1A/oxytocin antagonist registered for the treatment of imminent premature birth) was administered on the 14th day of endometrial synchronization for oocyte donation.


MAIN OUTCOME MEASURE(S): Uterine contractile activity (component of uterine receptivity) and success of treatment of infertility.


RESULT(S): Intense spontaneous uterine contractility was visualized by transvaginal sonography. After 1 hour of intravenous infusion of atosiban, a repeated scan showed a significant decrease in contractile activity (11 vs 7 contractions per 4 minutes, respectively). The ET was performed immediately after, and the infusion of atosiban continued for the next 2 hours. The treatment decreased the uterine contractile activity and resulted in successful embryo implantation and a normal twin diamniotic pregnancy.


CONCLUSION(S): Atosiban may improve uterine receptivity during ET and may increase success rates of advanced infertility treatment procedures.


Treatment with oxytocin antagonists before embryo transfer may increase implantation rates after IVF.
Moraloglu O, Tonguc E, Var T, Zeyrek T, Batıoglu S.


Dr. Zekai Tahir Burak Woman's Health Education and Research Hospital, Assisted Reproduction Unit, Ankara, Turkey.


Abstract
This report aimed to examine the effects of atosiban on pregnancy outcome after IVF-embryo transfer. A prospective, randomized, placebo-controlled clinical study was performed. A total of 180 women undergoing intracytoplasmic sperm injection who had top-quality embryos were randomly allocated into treatment and control groups. All the patients had infertility due to tubal factor, hormonal-anovulatory disorders, male factor or unexplained reasons. The treatment group received intravenous administration of atosiban before embryo transfer with a total administered dose of 37.5mg. In the control group, the same number of cycles was performed with placebo medication. The clinical pregnancy rate (PR) per cycle and implantation rate (IR) per transfer were 46.7% and 20.4% in the atosiban-treated group, which were significantly higher than in the control group (28.9% and 12.6%, respectively, P=0.01). The miscarriage rates of groups 1 and 2 were 16.7% and 24.4%, respectively (P=0.01). These results have indicated that atosiban increases the IR and PR after IVF-embryo transfer. These results suggest that atosiban treatment before embryo transfer is effective in priming of the uterus for implantation. This is the first study to investigate the possible contributions of atosiban for improving the PR after IVF-embryo transfer.
博元婦產科不孕症試管嬰兒中心:蔡鋒博醫師,陳昭雯醫師