添加重组黄体生成素对高龄患者体外受精-胚胎移植妊娠结局影响的Meta分析  

Effect of recombinant luteinizing hormone supplementation on the pregnancy outcome of elderly women undergoing in vitro fertilization-embryo transfer: a Meta-analysis

作　　者：王致辉[1] 巩晓芸[1] 赵静[1] 胡泊[1] 王鹏[1] 朱玥洁[1] 腊晓琳[1] Wang Zhihui;Gong Xiaoyun;Zhao Jing;Hu Bo;Wang Peng;Zhu Yuejie;La Xiaolin(Reproductive Medicine Department,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院生殖医学中心,乌鲁木齐830054

出　　处：《中华生殖与避孕杂志》2018年第11期911-919,共9页Chinese Journal of Reproduction and Contraception

基　　金：新疆维吾尔自治区自然科学基金(2017D01C284)~~

摘　　要：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=0.88)、种植率(RR=1.01,95%CI=0.74～1.38,P=0.94)及早期流产率(RR=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MⅡ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。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. Meta-analysis 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<0.00001) in both groups and metaphase II oocytes (WMD=-1.40, 95% CI=-1.79-1.01, P<0.00001) 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.

关 键 词：重组黄体生成素(rLH)高龄 体外受精-胚胎移植(IVF-ET)妊娠结局 META分析 

分 类 号：R714.8[医药卫生—妇产科学]