在凍融胚胎移植周期中對反覆種植失敗女性子宮內膜準備使用GnRHa預處理的效果.pdf
《在凍融胚胎移植周期中對反覆種植失敗女性子宮內膜準備使用GnRHa預處理的效果.pdf》由会员分享,可在线阅读,更多相关《在凍融胚胎移植周期中對反覆種植失敗女性子宮內膜準備使用GnRHa預處理的效果.pdf(5页珍藏版)》请在咨信网上搜索。
1、52Medical Journal of Kiang Wu,Jun 2023,Vol 23.No.1鏡湖醫學2023年6月第23卷第1期摘要目的 本薈萃分析的目的是探討GnRHa下調預處理在FET週期中對RIF女性子宮內膜準備和妊娠結局的影響。方法 檢索PubMed,EMBASE,Web of Science,Cochrane Library,CBM,CNKI,維普,和萬方數據庫,篩選2022年7月前的相關RCT研究。對子宮內膜厚度和臨床妊娠率進行統計累計效應量的meta分析。結果 最終納入3篇RCT研究,包括339個FET週期。干預組和對照組的年齡基線分析沒有統計學差異MD=010,95%C
2、I(-095,115),(Z=019,P=08501)。累計效應量提示,與對照組對比GnRHa預處理組有更厚的子宮內膜厚度MD=042,95%CI(-051,134),Z=089,P=03801 和更高的臨床妊娠率RR=147,95%CI(096,225),Z=178,P=007005,但是不具備統計學意義。Egger檢驗沒有發表偏倚(P=0185005)。結論 GnRHa預處理對RIF患者的FET週期結局有益,有增加子宮內膜厚度和提高臨床妊娠率的傾向。然而,並不具有統計學差異。因此,GnRHa預處理的效果仍需要大樣本的前瞻性研究來證實。關鍵詞 促性腺激素釋放激素激動劑;凍融胚胎移植;反覆種植
3、失敗;薈萃分析Effect of GnRHa pretreatment on endometrial preparationin RIF-FET women:a meta-analysisSUN Li Li 1*,GUAN Feng 2,WEI Wei 1,ZHANG Fan 1,CHEN Yi Hua 1,LIU Tian Ze 2 1.Reproductive Medicine Center,Affiliated Zhongshan Hospital of Dalian University,Dalian,China.2.Gynecology Department,Affiliated Z
4、hongshan Hospital of Dalian University,Dalian,China.3.Jiamusi University School of Medicine,Jiamusi,China.Abstract Objective The aim of this meta-analysis is to explore the effect of GnRHa down-regulation pretreatment on the endometrial preparation and the pregnancy/live birth rate in RIF-FET women.
5、Methods PubMed,EMBASE,Web of Science,Cochrane Library,CBM,CNKI,Weipu,and Wanfang databases were searched to identify relevant randomized control trials(RCTs).Studies before Jun,2022 were included for primary screening.Meta-analysis of the endometrium thickness and clinical pregnancy rate were conduc
6、ted.Results There was no statistical difference at baseline comparison of age MD=0.10,95%CI(-0.95,1.15),(Z=0.19,P=0.850.1).The final selection enrolled 3 RCTs,involving 339 FET cycles.Compared with control group,the pooled effective values indicated that GnRHa administration could improve endometriu
7、m thickness MD=0.42,95%CI(-0.51,1.34),Z=0.89,P=0.380.1 and clinical pregnancy rate RR=1.47,95%CI(0.96,2.25),Z=1.78,P=0.070.05,but there was no statistical difference.Egger regression test(P=0.1850.05)did not demonstrate any significance for the publication bias.Conclusion GnRHa pretreatment had a be
8、neficial role on the outcomes of FET cycles for RIF patients.There was a trend towards improved endometrium thickness and clinical pregnancy rate.However,the differences were not statistically significant.Therefore,additional large prospective studies were necessary on this topic.Key Words GnRHa;FET
9、;RIF;Meta-analysis在凍融胚胎移植周期中對反覆種植失敗女性子宮內膜準備使用GnRHa預處理的效果孫麗麗1*關峰2 魏巍1 張帆1 陳藝華1 劉天澤3 DOI:1012408/jissn2223-4462202301012作者單位1 大連大學附屬中山醫院生殖醫學中心 遼寧大連 2 大連大學附屬中山醫院婦科 遼寧大連 3 佳木斯大學醫學部 黑龍江佳木斯*通訊作者 E-mail:18610927839163com臨床研究IntroductionThe use of FET is increasing worldwide in the treatment of infertility
10、by IVF.Because it can reduce both the occurrence of multiple pregnancies and the incidence of OHSS,and can be used as a remedy for those who have not been pregnant during the IVF-ET cycles or have been cancelled ET for various reasons.Compared 53Medical Journal of Kiang Wu,Jun 2023,Vol 23.No.1鏡湖醫學20
11、23年6月第23卷第1期to fresh embryo transfer,FET is simpler and easier to implement,less painful for the patient and reduce treatment time and financial expenses.In countries that strictly implement the single embryo transfer strategy,FET is performed in 50-80%of cases1.There is no standard conclusion on th
12、e choice of FET schemes,comparing to the diversity of superovulation promotion schemes.The most commonly used FET protocol is the traditional HRT 2,3.The key to the success of FET is the receptivity of the endometrium synchronized with embryonic development,so the preparation of the endometrium is v
13、ery important,particularly in the RIF patients.RIF is defined as failure of implantation in at least three consecutive embryo transfers,in which 1-2 embryos of high-grade quality are transferred in each cycle4.RIF has always been a conundrum in assisted reproduction.Under the premise of high-quality
14、 embryo to transfer,a functioning and receptive endometrium is crucial for embryo implantation.The endometrial preparation methods include those for conventional natural cycle,artificial cycle,and ovulation induction cycle.In recent years,GnRHa has been applied for pituitary down-regulation before h
15、ormone replacement to prepare the endometrium.The programmed cycles using GnRHa before HRT,aim to achieve pituitary down-regulation and to avoid spontaneous ovulation5.However,GnRHa administration increases the costs and number of treatment cycles.Its effect on pregnancy outcomes remains controversi
16、al.Several studies claimed no difference in pregnancy outcomes between HRT and HRT with GnRHa pretreatment6-9;in the contrary,some prospective studies showed that pregnancy outcomes were significantly improved by GnRHa pretreatment in HRT cycles10,11.For women with RIF,whether GnRHa immune and infla
17、mmatory inhibitory effects may increase pregnancy rates or not is worth exploring.Until now,there is no systematic review on this topic.Therefore,this meta is designed to explore whether the use of GnRHa before hormone supplementation of the endometrial preparation in FET cycles can improve pregnanc
18、y rate in women with RIF.Methods and proceduresThe protocol of this review was registered in PROSPERO(CRD42021234758).RCTs comparing GnRHa treatment versus the control were included in this meta-analysis.Exclude retrospective studies and small observational studies were excluded.We collected the rel
19、evant studies by searching the databases of PubMed,EMBASE,Web of Science,Cochrane Library,CBM,CNKI,Weipu,and Wanfangfrom 1991 to Jun 2022,using the search strategy(e.g.PubMed):(frozen embryo transfer)OR(FET)OR(frozen-thawed embryo transfer)OR(AC-FET)AND(Gonadotropin-Releasing Hormone agonist)OR(GnRH
20、a)OR(Gonadotropin releasing hormone analogues)OR(Gonadotropin-Releasing Hormone)OR(Gonadotropin releasing hormone agonist)OR(downregulation)OR(down regulation)OR(GnRHa pretreatment)OR(Pituitary down regulation)OR(Pituitary down-regulation pretreatment)AND(recurrent implantation failure)OR(RIF)AND(ra
21、ndomized controlled trial Publication Type OR randomizedTitle/Abstract OR placebo Title/Abstract).There were no limitations on the type of the publication.English or Chinese language was accepted.We also searched for study protocols and ongoing trials in Clinical Trials(https:/clinicaltrials.ov/)and
22、 ChiCTR(https:/ of retrieved articles were also screened.Our primary outcome measure was clinical CPR per woman randomly assigned,and the secondary endometrial thickness.All literatures were reviewed independently by two authors.The flow chart for study selection was shown in Fig.1.Two authors extra
23、cted data independently and in duplicate,and reached on all items including authors last name,journal and year of publication,country of origin,ethnicity of the patients,definition of RIF,count of each event in GnRHa group and the control.The results were compared and disagreements were discussed an
24、d resolved with consensus.Statistics The pooledRR and its 95%confidence interval(CI)were estimated to assess the role of GnRHa treatment on the CPR of FET.The pooled RRs were calculated through a Mantel-Haenszel fixed effects model if there was no heterogeneity.Otherwise,a random-effects model was a
25、dopted.For continuous variable,the pooled MD of endometrial thickness,I-V heterogeneity was formally tested using Stata 16.0 software.The I2 statistic was examined and I250%was considered significant for the heterogeneity between studies.Publication bias across studies was assessed using the Eggers
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- 胚胎 移植 周期 中對反覆種植失敗 女性 子宮內膜準備 使用 GnRHa 預處理 效果
1、咨信平台为文档C2C交易模式,即用户上传的文档直接被用户下载,收益归上传人(含作者)所有;本站仅是提供信息存储空间和展示预览,仅对用户上传内容的表现方式做保护处理,对上载内容不做任何修改或编辑。所展示的作品文档包括内容和图片全部来源于网络用户和作者上传投稿,我们不确定上传用户享有完全著作权,根据《信息网络传播权保护条例》,如果侵犯了您的版权、权益或隐私,请联系我们,核实后会尽快下架及时删除,并可随时和客服了解处理情况,尊重保护知识产权我们共同努力。
2、文档的总页数、文档格式和文档大小以系统显示为准(内容中显示的页数不一定正确),网站客服只以系统显示的页数、文件格式、文档大小作为仲裁依据,平台无法对文档的真实性、完整性、权威性、准确性、专业性及其观点立场做任何保证或承诺,下载前须认真查看,确认无误后再购买,务必慎重购买;若有违法违纪将进行移交司法处理,若涉侵权平台将进行基本处罚并下架。
3、本站所有内容均由用户上传,付费前请自行鉴别,如您付费,意味着您已接受本站规则且自行承担风险,本站不进行额外附加服务,虚拟产品一经售出概不退款(未进行购买下载可退充值款),文档一经付费(服务费)、不意味着购买了该文档的版权,仅供个人/单位学习、研究之用,不得用于商业用途,未经授权,严禁复制、发行、汇编、翻译或者网络传播等,侵权必究。
4、如你看到网页展示的文档有www.zixin.com.cn水印,是因预览和防盗链等技术需要对页面进行转换压缩成图而已,我们并不对上传的文档进行任何编辑或修改,文档下载后都不会有水印标识(原文档上传前个别存留的除外),下载后原文更清晰;试题试卷类文档,如果标题没有明确说明有答案则都视为没有答案,请知晓;PPT和DOC文档可被视为“模板”,允许上传人保留章节、目录结构的情况下删减部份的内容;PDF文档不管是原文档转换或图片扫描而得,本站不作要求视为允许,下载前自行私信或留言给上传者【自信****多点】。
5、本文档所展示的图片、画像、字体、音乐的版权可能需版权方额外授权,请谨慎使用;网站提供的党政主题相关内容(国旗、国徽、党徽--等)目的在于配合国家政策宣传,仅限个人学习分享使用,禁止用于任何广告和商用目的。
6、文档遇到问题,请及时私信或留言给本站上传会员【自信****多点】,需本站解决可联系【 微信客服】、【 QQ客服】,若有其他问题请点击或扫码反馈【 服务填表】;文档侵犯商业秘密、侵犯著作权、侵犯人身权等,请点击“【 版权申诉】”(推荐),意见反馈和侵权处理邮箱:1219186828@qq.com;也可以拔打客服电话:4008-655-100;投诉/维权电话:4009-655-100。