辅助孵化对反复种植失败者临床结局影响的系统评价

发布时间：2019-03-17 12:58

【摘要】：目的：系统评价辅助孵化(AH)对反复种植失败(RIF)患者再次助孕治疗的临床妊娠结局的影响。方法：计算机检索Cochrane图书馆、MEDLINE、中国生物医学文献数据库、相关期刊论文、中文科技期刊全文数据库、万方数据库,检索时限至2013年10月。纳入在RIF患者应用AH的随机对照试验,由两名评价员独立提取资料,并对其方法学质量进行评价。对符合纳入标准的研究用RevMan5.0软件进行Meta分析。结果：共检索到符合纳入标准随机对照的文献7篇,共有研究对象1621例,其中AH组793例,对照组828例。Meta分析结果显示：与对照组对比,AH组的临床妊娠率显著提高[OR=1.99,95%CI(1.22,3.23),P=-0.006],每胚胎的种植率亦显著提高[OR=2.11,95%CI(1.17,3.80),P=0.01]；AH组与对照组的活产率比较,AH组的活产率更高且差异有统计学意义[OR=2.04,95%CI(1.07,3.89),P=0.03]；但对于多胎妊娠率的比较,对照组的多胎妊娠率相对较低且差异有统计学意义[OR=1.58,95%CI(1.05,2.37),P=0.03]；流产率比较两组无统计学差异[OR=I.62,95%CI(0.75,3.50),P=0.22]。结论：AH可以改善RIF患者再次助孕治疗的某些临床结局,如提高妊娠率、每胚胎种植率和活产率。AH不会增加流产率,但有增加多胎妊娠率的风险。由于纳入研究方法学质量、样本量所限,该结论尚需大样本、高质量的随机对照试验进一步证实。
[Abstract]:Objective: to evaluate the effect of assisted hatching (AH) on the pregnancy outcome of repeated implantation failed (RIF) patients. Methods: the Cochrane Library, MEDLINE, Chinese Biomedical Literature Database, Chinese Journal full-text Database, Chinese sci-tech Journal full-text Database and Wanfang Database were searched by computer. The time limit of retrieval was up to October 2013. A randomized controlled trial of AH was used in patients with RIF. The data were extracted independently by two evaluators and their methodological quality was evaluated. Meta analysis was carried out with RevMan5.0 software for the research which met the inclusion criteria. Results: a total of 7 randomized controlled articles were found. There were 1621 subjects, including 793 cases in AH group and 828 cases in control group. The results of meta-analysis showed that: compared with the control group, there were 793 cases in the study group and 828 cases in the control group. The clinical pregnancy rate in AH group was significantly increased [OR=1.99,95%CI (1.22,3.23), P < 0.006], and the implantation rate per embryo was also significantly increased [OR=2.11,95%CI (1.17,3.80), P0. 01]. The survival rate of AH group was higher than that of control group [OR=2.04,95%CI (1.07, 3.89), P < 0.05]. The survival rate of AH group was significantly higher than that of control group [OR=2.04,95%CI (1.07, 3.89), P < 0.05]. However, the multiple pregnancy rate of the control group was lower than that of the control group [OR=1.58,95%CI (1.05, 2.37), P = 0.03], but the multiple pregnancy rate of the control group was significantly lower than that of the control group (1.05, 2.37). There was no significant difference in abortion rate between the two groups [OR=I.62,95%CI (0.75, 3.50), P = 0.22]. Conclusion: AH can improve some clinical outcomes of RIF patients, such as increasing pregnancy rate, per embryo implantation rate and living rate. AH does not increase abortion rate, but has the risk of increasing multiple pregnancy rate. Due to the quality of the research methodology and the limited sample size, the conclusion needs to be further confirmed by a high-quality randomized controlled trial.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.8

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