Objective To evaluate the necessity of recombinant luteinizing hormone (rLH) supplementation in elderly women.Methods We electronically searched biomedical databases such as Pubmed,EMbase,Ovid Medline and Cochrane library.Randomized controlled trials (RCTs) were identified about rLH supplementation in women of 35 years or older.Study selection and Meta-analysis were conducted which according to the Cochrane Handbook for systematic reviews.Date were extracted from these trials by 3 reviewers independently and analyzed by RevMan5.3 software.Results A total of 9 RCTs involving 1 469 cases were included,of which 736 cases were in experimental group while the other 733 cases were in control group.Metaanalysis indicated that,rLH supplementation had no beneficial on the clinical pregnancy rate (RR=1.00,95％ CI=0.84-1.19,P=0.97),the live-birth rate (RR=1.01,95％ CI=0.84-1.23,P=0.88),the implantation rate (RR=1.01,95％ CI=0.74-1.38,P=0.94) and the early miscarriage rate (RR=1.10,95％ CI=0.71-1.69,P=0.68).However,it reduced the No.of oocytes retrieved (WMD=-1.55,95％ CI=-1.78--1.31,P＜0.000 01) in both groups and metaphase Ⅱ oocytes (WMD=-1.40,95％ CI=-1.79--1.01,P＜0.000 01) in patients with GnRH agonist protocol.Conclusion rLH supplementation can significantly reduce the No.of oocytes retrieved in both groups and metaphase Ⅱ oocytes in patients with a GnRH agonist protocol,and no significant differences were found between the two groups in parameters of pregnancies.%目的 评价高龄患者添加重组黄体生成素(rLH)的必要性.方法 计算机检索PubMed、EMbase、Ovid Medline、Cochrane Library等中外生物医学数据库.筛选出高龄患者促排卵方案中是否添加rLH的随机对照研究(RCTs).按Cochrane系统评价的方法对所纳入的研究进行质量评价,并提取相关数据,采用RevMan5.3软件进行分析.结果 共纳入9个RCTs,1 469例患者,试验组736例,对照组733例.Meta分析结果显示:高龄患者添加rLH对临床妊娠率(RR=1.00,95％ CI=0.84～1.19,P=0.97)、活产率(RR=1.01,95％ CI=0.84～1.23,P=o.88)、种植率(RR=1.01,95％ CI=0.74～1.38,P=0.94)及早期流产率(gg=1.10,95％CI=0.71～1.69,P=0.68)无影响,但降低了获卵数(WMD=-1.55,95％ CI=-1.78～-1.31,P＜0.000 01)及激动剂方案中M Ⅱ卵数(WMD=-1.40,95％ CI=-1.79～-1.01,P＜0.000 01).结论 高龄患者添加rLH会减少获卵数及激动剂方案中的MⅡ卵数,但对临床妊娠率、活产率、种植率及早期流产率无影响.
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