Survival analysis of the effect of water intake on bladder filling time in embryo transfer patients:a randomized control trial
Objective To investigate the effect of water intake on bladder filling time before embryo transfer.Methods A total of 189 patients were collected from February to June 2023 who were to undergo embryo transfer in Guangdong Women and Children Hospital.The patients were divided into group A(n=61),group B(n=64)and group C(n=64)using a random number table and they were respectively given 300 mL,500 mL and 700 mL water to drink.Abdominal ultrasound was performed every 15 min,a total of 1-5 times,from 45 min after drinking water until the bladder filling.The bladder filling time and bladder volume were collected.Kaplan-Meier method was used to compare the difference of bladder filling time among the three groups.The multivariate Cox regression was used to analyze factors of bladder filling time.Results The cumulative bladder filling rates of group A,group B and group C at 105 min after drinking water were 57.4％(35/61),90.6％(58/64)and 98.4％(63/64),respectively,and the median survival time(95％CI)of bladder filling was 105.0(89.9-120.1)min,60.0(55.4-64.7)min and 60.0(55.4-64.6)min,respectively.Pairwise comparison of Kaplan-Meier analysis revealed that the bladder filling time of group A was longer than that of group B and group C(P＜0.001),and there was no statistically significant difference between group B and group C(P＞0.05).The results of age-stratification analysis showed that the bladder filling time of younger patients in group A[90.0(75.2-104.8)min]was longer than that in group B[60.0(55.8-64.2)min,P＜0.001]and group C[60.0(55.1-64.8)min,P＜0.001],and there was no statistical significance between group B and group C(P＞0.05);the bladder filling time of older patients in group C[60.0(59.1-70.9)min]was shorter than that in group A[105.0(89.9-120.1)min,P＜0.001]and group B[75.0(64.3-85.7)min,P=0.027],there was no statistical significance between group A and group B(P＞0.05).Multivariate Cox regression analysis showed that taking group A as reference,the hazard ratio(HR,95％CI)of groups B and C were 2.71(1.78-4.21)and 3.23(2.10-4.96),both P＜0.001.The HR(95％CI)of the elderly patients was 0.69(0.49-0.99),P=0.044.Conclusion Water intake and age are independent factors affecting bladder filling time in embryo transfer patients.Patients are recommended to drink 500 mL of water 75 min before embryo transfer and appropriately increase the amount of water or extend the bladder preparation time after drinking water for elderly patients.
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