GnRH激动剂应用于子宫内膜准备对冻胚移植后妊娠结局影响的meta分析

摘要

目的 通过meta分析的方式评估GnRH激动剂(GnRH-a)应用于子宫内膜准备前应用GnRH-a对冻胚移植后的着床情况和妊娠结局的影响. 方法 采用计算机检索方法,收集中国科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方等中文数据库以及PubMed、Embase、Cochrane Library、SCIENCE、springe等外文数据库,同时根据以上检索所得文献的参考文献进行扩大检索冻胚移植周期子宫内膜准备的随机对照试验和前瞻性研究文献,提取相关数据资料,采用Cochrane协作网提供的RevMan5.3统计软件进行Meta分析. 结果 共纳入5项符合标准的研究,共计872例患者.其中降调组439例,无降调组433例,结果显示,冻胚移植前应用GnRH-a相对于不用GnRH-a在种植率上无明显差异,结果不具有统计学意义[RR=1.01,95％CI(0.80,1.28),P=0.91],在临床妊娠率也无统计学差异[RR=1.12,95％CI(0.74,1.70),P=0.59]. 结论 通过本次Meta分析发现,子宫内膜准备中是否应用GnRH-a对种植率和妊娠率无明显统计学差异.%Objective:To assess the implantation and pregnancy outcome in frozen-thawed embryo transfer cycle by using GnRH agonist (GnRH-a) for endometrial preparation with Meta analysis.Methods:The literatures about the regimen of endometrial preparation in frozen-thawed embryo transfer cycles in the randomized controlled trials or prospective studies were searched from VIP,CBM,CNKI,Wanfang database,PubMed,Embase,Cochrane Library,SCIENCE database and references to enlarging the relative literatures.Then the literatures were systematically evaluated by Meta analysis with RevMan5.3.Results:Five eligible studies with a total of 872 patients were included.There were 439 patients with using GnRH-a group and 433 patients in without using GnRH-a group.Meta analysis showed that there were no significant differences in embryo implantation rate (RR=1.01,95％CI(0.80,1.28),P=0.91) or clinical pregnancy rate (RR=1.12,95％C(0.74,1.70),P=0.59) between the two groups.Conclusions:The Meta analysis results show that whether GnRH-a is used for endometrial preparation had no significant difference in implantation rate and pregnancy rate.