آثار قرص پیشگیری از بارداری بر موفقیت باروری لقاح آزمایشگاهی

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشیار گروه زنان و زایمان، دانشکده پزشکی دانشگاه علوم پزشکی بابل

2 مربی گروه مامایی، دانشکده پزشکی دانشگاه علوم پزشکی بابل

3 استادیار گروه زنان و زایمان، دانشکده پزشکی دانشگاه علوم پزشکی بابل

چکیده

مقدمه: این مطالعه به منظور تعیین تأثیر قرص های پیشگیری از بارداری در دوره درمانی قبل از لقاح
آزمایشگاهی براین نوع باروری طراحی شد.
روش کار: این مطا لعه کارآزمایی بالینی تصادفی کنترل شده، در مرکز ناباروری فاطمهالزهـراء دانـشگاه
علوم پزشکی بابل از سال1383 -84 انجام شد. 102 زن با علت ناباروری لولـهای، چـسبندگی لگنـی، دوره
طبیعی تخمکگذاری، سن کمتر از40 سال و فاقد اخـتلالات عامـل مردانـه، وارد مطالعـه شـدند. 51 زن در
دوره قبل از درمان لقاح آزمایشگاهی، قرص پیشگیری از بارداری مصرف کردنـد و همـین تعـداد زن هـیچ
درمان دارویی قبل از دوره درمـانی دریافـت نکردنـد. دسـتورالعمل حـساسیتزدایـی هیپـوفیز بـا آنـالوگ
GnRH در هر دو گروه به طور مشابه استفاده شد که برحسب شرایط فردی ، سـن، میـزان FSH مرحلـه
اولیه فولیکولر، تعداد آمپولهای گنادوتروپین تنظـیم شـد. هـر دو گـروه از نظـر میـانگین سـن، طـول مـدت
ناباروری، LH ,FSH مرحله فولیکولر اولیه و علت ناباروری یکسان بودنـد. همچنـین دوبـار سـونوگرافی
مهبلی، یک بار قبل از دوره درمانی در زمان قاعدگی و بـار دوم در شـروع دوره و روز سـوم، بـه منظـور
2 تشخیص عارضه کیستتخمدانی انجام شد. در تجزیه و تحلیـل آمـاری از آزمونهـای تـی،
X و تجزیـه و
تحلیل رگرسیون چند متغیره استفاده شد.
نتـایج: میـانگین تعـداد فولیکولهـا در مـصرف کننـدگان قـرص ضـد بـارداری نـسبت بـه گـروه کنتـرل
اخـتلاف (6/6 ± 5/5 مقابـل در 5/7 ± 4/1) شـده اسـتخراج تخمکهای و (8/8 ± 4/6مقابل در 6/4 ± 3/7)
معنی داری نداشت. در گروه مصرف کننده قرص های پیشگیری از بارداری، تعداد آمپولهای hMG در هر
مقابـل در 15/8 ± 11/8)در گنادوترویینی تحریک مدت طول و (34/8± 14/6 مقابل در 39/9 ± 19/5 )دوره
13/5 ± 7/1) به طور معنی داری بیشتر از گروه کنترل بود (p<0/05). میزان بروز عارضه تـشکیل کیـست
تخمدان در دو گروه یکسان بود.
نتیجه گیری: مصرف قرص های پیـشگیری از بـارداری در دوره قبـل ازلقـاح آزمایـشگاهی ، بـر بهبـود
باروری تاثیر نداشت. 

کلیدواژه‌ها


عنوان مقاله [English]

The Effects of Oral Contraceptive Pills on Fertilization in IVF Cycle

نویسندگان [English]

  • Sedigheh Esmailzadeh 1
  • Mahboubeh Faramarzi 2
  • Mahtab Zinalzadeh 3
  • Tahere Nazari 3
چکیده [English]

Introduction: This study was planned to determine the effects of the administration of pretreatment oral contraceptive pills on in vitro fertilization.
 
Material and Methods: A clinical randomized controlled trial was conducted in Fatemeh – Alzahra Hospital of Babol University of Medical Sciences from 2004 – 2005, on 102 women with tubal or pelvic adhesive disease as the cause of their infertility, normal ovulatory cycle, of age under 40 years, and no male factor. Pretreatment with oral contraceptive pills was administered for 51 patients, and a similar number of women did not receive any pretreatment. The flare protocol was used in all treatment cycles combined with an individualized dose of human menopausal gonadotrophin depending on previous response, age, and early follicular stage serum FSH level. Both groups were similar in the mean of women’s age, the duration of infertility, the mean of FSH and LH levels, and the distribution of various infertility etiologies. Transvaginal ultrasonograghy was performed twice in pre-treatment cycle and initial cycle on day 2 to identify complication of ovarian cysts formation.
 
Results: The mean number of follicles (6. 4 ± 3.7 vs 8.8± 4.6) and oocyte retrieved 5.7± 4.7 vs 6.6 ± 5.5) were similar in OCP and control groups. OCP group had significantly the mean number of administration of ampoules of hMG used per cycle (39.9 ± 19.5 vs 34.8± 14.6) and the duration of ovarian stimulation (75.8± 11.8 vs 13.5 ± 7.1) more than the control group (P < %5). The ovarian cyst formation was similar in the two groups. Fertilization rate had no significant difference between OCP and control group (%54 vs 43%). In multivariate analysis, independent predictors of clinical fertilization were women’s age with negative correlation and the number of oocytes with positive correlation.
 
Conclusion: Pre- treatment of OCP cycle with oral contraceptives did not improve fertilization OCP cycle

کلیدواژه‌ها [English]

  • oral contraceptive pills
  • in vitro fertilization
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