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三分之一的試管嬰兒診所提供子宮內膜刮擦服務

游海 2021-12-28 11:04 試管之家 查看: 35 評論: 0

摘要:   根據最新調查,目前英國、澳大利亞和新西蘭34%的試管嬰兒診所提供子宮內膜刮擦服務?! ≡摮绦蚴亲鳛闃藴试嚬軏雰褐委煹母郊映绦蜻M行的,涉及使用導管有意劃傷子宮內膜以引起炎癥反應。澳大利亞墨爾本莫納什大 ...
  根據最新調查,目前英國、澳大利亞和新西蘭34%的試管嬰兒診所提供子宮內膜刮擦服務。

  該程序是作為標準試管嬰兒治療的附加程序進行的,涉及使用導管有意劃傷子宮內膜以引起炎癥反應。澳大利亞墨爾本莫納什大學的研究人員匿名詢問了121位生育專家、胚胎學家和生育護士,他們的診所是否進行了該手術,以及他們是否認為這樣做有益。他們的結果發表在Human Fertility上,發現不到10%的人認為它可以改善懷孕結果,但有34%的診所提供它。

  由于子宮內膜刮擦的工作原理以及它是否會增加活產機會的不確定性,該主題引起了大量爭論。來自澳大利亞墨爾本大學的Sarah Lensen博士和該研究的一位作者告訴Inverse,“我們沒有充分的證據表明子宮內膜刮擦有助于人們通過試管嬰兒獲得嬰兒,這是一個痛苦的過程,與患者的費用也是如此”。

  在同一項調查中,29%的生育專家認為,子宮內膜刮擦可能對特別因反復植入失敗而苦苦掙扎的女性有利。Lensen博士意識到這可能會推動在診所繼續使用子宮內膜刮擦術。

  在被問及的人中,55%的人認為抓撓子宮內膜可以減輕心理困擾。Lensen博士的理解是,“這些額外的治療有助于保持希望,并幫助患者在非常不確定的時期內更有控制感”。

  在過去五年中,對該程序的態度發生了變化;Lensen博士之前在2016年發表在《人類生殖》雜志上的一項研究發現,生育領域83%的專業人士建議進行子宮內膜刮擦。后續調查的分析表明,51%以前提供子宮內膜刮擦的診所不再提供。

  Lensen博士認為,這種差異可歸因于更多高質量的研究發表。該團隊對提供子宮內膜刮擦的診所數量下降感到鼓舞,這證明提供者正在傾聽研究并采取行動將患者的健康考慮在內。

  在全球范圍內,有4800萬對夫婦受到不孕癥的影響。隨著子宮內膜刮擦等附加項目變得越來越流行,澳大利亞團隊將繼續他們的研究,旨在為患者提供資源,幫助他們就自己的護理做出明智的決定。

以下原文:
  Endometrial scratching offered by 1/3 of IVF clinics

  Endometrial scratching is currently being offered by 34 percent of IVF clinics in the UK,Australia,and New Zealand,according to a latest survey.

  The procedure is performed as an add-on to standard IVF treatments and involves the use of a catheter to intentionally scratch the endometrium to cause an inflammatory response.Researchers at Monash University in Melbourne,Australia,anonymously asked 121 fertility specialists,embryologists,and fertility nurses whether their clinic performed the procedure and whether they thought it was beneficial.Their results,published in Human Fertility,found that less than 10 percent believed it improved pregnancy outcomes but that it was being offered by 34 percent of clinics.

  The topic has attracted a great deal of debate due to uncertainty regarding how endometrial scratching works and whether it increases the chances of live birth.Dr Sarah Lensen from the University of Melbourne,Australia,and one of the authors of the study told Inverse,'We don't have good evidence that endometrial scratching helps people to have a baby from IVF,and it's a painful procedure associated with a cost for the patient too'.

  In the same survey,29 percent of fertility specialists believed that endometrial scratching could be advantageous in women struggling specifically with recurrent implantation failure.Dr Lensen appreciates that this might be driving the continued use of endometrial scratching in clinics.

  Of those asked,55 percent believe that endometrial scratching offers a reduction in psychological distress.Dr Lensen's understanding is that'these extra treatments help to keep the hope alive and help patients to feel more in control in a very uncertain time'.

  Attitudes towards the procedure have shifted over the last five years;a previous study by Dr Lensen,published in Human Reproduction in 2016,found that 83 percent of professionals within the fertility sector recommended endometrial scratching.Analysis from the follow-up survey showed that 51 percent of clinics that previously offered endometrial scratching,no longer do.

  Dr Lensen believes the disparity can be attributed to a greater number of high-quality studies being published.The team are encouraged by the decline in the number of clinics offering endometrial scratching,proving that providers are listening to the research and acting to take patient's wellbeing into account.

  Globally,48 million couples are affected by infertility.With add-ons,such as endometrial scratching,becoming increasingly popular,the Australian team will continue their research with an aim to provide resources to patients to aid them in making informed decisions about their care.

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