基因重组促卵泡激素(FSH)与尿源性FSH用于体外受精-胚胎移植的Meta分析  

Application of recombinant human FSH and urinary FSH in IVF-ET:a Meta analysis

作　　者：叶虹[1] 黄国宁[1] 

机构地区：[1]重庆妇幼保健院,重庆400010

出　　处：《生殖与避孕》2015年第2期99-108,共10页Reproduction and Contraception

摘　　要：目的:比较体外受精(IVF)或卵胞质内单精子注射(ICSI)治疗周期基因重组促卵泡激素(rFSH)与尿源性促卵泡激素(uFSH)在控制性促排卵(COS)中的有效性。方法:检索Pub Med、EMBASE、Cochrane,CNKI及万方数据库中自rFSH上市至2013.09前发表的文章,收集rFSH与uFSH在IVF或ICSI中应用的随机对照研究,对纳入的研究进行质量评价,提取数据,采用Rev Man5.2软件对IVF或ICSI治疗周期的获卵数、FSH总用量、周期出生率、临床妊娠率、持续妊娠率、卵巢过度刺激综合征(OHSS)的相对有效性进行Meta分析。结果:共纳入21篇研究,6 496个周期。总体上,rFSH较uFSH获卵数更多,FSH总用药量更少,差异有显著统计学意义;周期出生率和临床妊娠率r FSH和u FSH之间无显著性差异。结论:rFSH较uFSH在辅助生殖中具有更好的COS有效性。Objective： To evaluate the role and efficacy in controlled ovarian stimulation（COS） of recombinant FSH（rFSH） and urinary FSH（uFSH） during in vitro fertilization（IVF） and intracytoplasmic sperm injection（ICSI） therapy. Methods： Prospectively randomized controlled studies of the use of r FSH and u FSH in IVF and ICSI treatment were enrolled in this study from Pub Med, EMBASE, Cochrane, CNKI and Data Base of Wanfang. After quality assessment and data extraction, Meta analysis was conducted under the assessment of odds ratio（OR） and mean difference（MD） by Rev Man 5.2 software. Results： A total of 21 randomized controlled trail（RCT） studies were enrolled in this study after excluding poor quality and repeat published studies. The patients were further divided into 3 subgroups according to the types of u FSH. There was a significant difference in oocytes retrieved numbers between the two groups, rFSH was more effective [MD=1.40, 95%CI=0.79-2.02（Z=4.46, P〈0.000 01）]. There was a significant difference in FSH dosage between the two groups, rFSH needed less total dosage of FSH [MD=-222.56, 95%CI=-383.24--61.88（Z=2.71, P=0.007）]. There was no significant difference in the birth rate of cycle, clinical pregnancy rate. Conclusions： r FSH is more effective than u FSH in COS during assiting reproduction.

关 键 词：基因重组促卵泡激素(rFSH) 尿源性促卵泡激素(uFSH) 体外受精(IVF) 卵胞质内单精子注射(ICSI) 生殖 META分析 

分 类 号：R714.8[医药卫生—妇产科学]