GnRH拮抗剂方案及GnRH-a短方案用于卵巢低反应患者助孕临床疗效Meta分析

发布时间：2018-01-28 23:45

本文关键词： 卵巢低反应促性腺激素释放激素激动剂短方案促性腺激素释放激素拮抗剂 Meta分析　出处：《生殖医学杂志》2015年04期 　论文类型：期刊论文

【摘要】：目的比较卵巢低反应(POR)患者行促性腺激素释放激素拮抗剂(GnRH-ant)及GnRH激动剂(GnRH-a)短方案的临床疗效。方法计算机检索PubMed、ProQuest Medical Library、Medline外文生物医学期刊文献数据库、中国生物医学文献数据库(CBM)、中国知网(CNKI)、中国科技期刊数据库(VIP)、万方数据库和读秀学术搜索引擎等。收集2000年至2014年10月发表的相关文献,比较POR患者行GnRH-ant及GnRH-a短方案的临床试验,按Cochrane系统评价方法提取有效数据,采用RevMan 5.2软件进行Meta分析。结果共纳入11篇文献,共855例(1 054个周期)POR患者,其中GnRHant组444例(549个周期),GnRH-a短方案组411例(505个周期);Meta分析结果显示:对于POR患者,两组间临床妊娠率[RR=1.25,95%CI(0.96,1.63),P=0.10]、促性腺激素(Gn)时间[WMD=-1.15,95%CI(-2.56,0.25),P=0.11]、Gn用量[WMD=63.54,95%CI(-59.08,186.17),P=0.31]、获卵数[WMD=0.16,95%CI(-0.66,0.98),P=0.70]、周期取消率[RR=1.07,95%CI(0.85,1.35),P=0.57]差异均无统计学意义,但临床妊娠率的结果偏向于拮抗剂组更优。结论对于POR患者,拮抗剂方案和GnRH-a短方案效果无统计学差异,但是拮抗剂组可能更有助于提高临床妊娠率,可以作为POR患者助孕的一个选择。
[Abstract]:Objective to compare gonadotropin releasing hormone antagonist (GnRH-antant) and GnRH agonist (GnRH-a) in patients with ovarian hyporesponsiveness (POR). Methods PubMed was searched by computer. ProQuest Medical Library Medline Foreign Biomedical Journal Literature Database, Chinese Biomedical Literature Database (CBM). CNKI, China Science and Technology Journal Database, Wanfang Database and Yuxiu academic search engine, etc. Relevant documents published from 2000 to October 2014 were collected. To compare the clinical trials of GnRH-ant and GnRH-a in patients with POR, and to extract effective data according to Cochrane system evaluation method. RevMan 5.2 software was used to analyze Meta. Results A total of 855 patients with 1 054 cycles were included in 11 literatures. There were 444 patients with GnRH-a short regimen in GnRHant group, 444 patients with GnRH-a short regimen, 444 patients with GnRH-a short regimen had 505 cycles. The results of Meta analysis showed that for patients with POR, the clinical pregnancy rate between the two groups. [RRR 1.25 / 95 CI 0.96 / 1.63 / P0. 10) time of gonadotropin. [WMD-1.15 / 95 / WMD-2.56 / 0.25 / P ~ (0.11) / g ~ (-1) / g ~ (-1) / g ~ (-1) / g ~ (2 +). [WMD63.54 / 95 / CI-59.08 / 186.17 / 0.31, number of eggs obtained. [WMD0.16 / 95 / CI-0.66 / 0.98 / P0. 70 /, cycle cancellation rate. [There was no significant difference in RRX 1.07 ~ 95CII 0.85 ~ 1.35 ~ (0.57) (P ~ (0.57)). But the results of clinical pregnancy rate preferred to the antagonist group. Conclusion for POR patients, there is no statistical difference between the effect of antagonist regimen and GnRH-a short regimen. But the antagonist group may be more helpful to improve the clinical pregnancy rate, which may be an option for POR patients.
【作者单位】：武汉大学人民医院生殖中心;
【分类号】：R714.8
【正文快照】： Results:Eleven articles met the inclusion criteria and included 855patients(1054cycles).There were444patients(549cycles)in the GnRH antagonist protocol group and 411patients(505cycles)in GnRH-ashort protocol group.Meta-analysis showed that there were no

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