二甲双胍对体外受精/卵胞质内单精子显微注射中多囊卵巢综合征患者妊娠结局有效性的系统评价  

Pregnancy outcome of metformin in patients with polycystic ovary syndrome undergoing IVF/ICSI: a systematic review

作　　者：孙东霞[1] 翟军[1] 王靖媛[1] 董方莉[1] 张莹莹[1] 

机构地区：[1]郑州大学第一附属医院生殖中心,郑州450052

出　　处：《生殖与避孕》2016年第2期119-127,共9页Reproduction and Contraception

摘　　要：目的：系统性评价二甲双胍对常规体外受精／卵胞质内单精子显微注射（IVF／ICSI）中多囊卵巢综合征（PCOS）患者妊娠结局的有效性。旨在为助孕前的干预措施提供理论依据。方法：计算机检索中国学术期刊全文数据库（CNrd）、万方数据库、维普数据库、PubMed、Medline、Embase有关二甲双胍对IVF／ICSI中PCOS患者妊娠结局的l临床随机对照试验（RCT）。按Cochrane系统评价方法，首先对纳入的文献进行质量评价和资料提取后，采用RevMan5．2软件进行Meta分析。结果：纳入11个RCT研究，共1310例患者，其中二甲双胍组713例，对照组597例。Meta分析结果显示：与对照组相比较，二甲双胍组的临床妊娠率（OR=1．60，95％CI：1．26～2．04，P=0．0002）较高，卵巢过度刺激综合征（onss）发生率较低（OR=0．45，95％CI：0．31～0．64，P=0．0001）。而活产率（OR=1．38，95％CI：0．98～1．94，P=0．06）和流产率（OR=0．72，95％CI：0．51～1．02，P=-0．07）组间无统计学差异。结论：二甲双胍可提高IVF／ICSI中PCOS患者的妊娠率、降低oHSS发生率，但不能提高活产率及降低流产率。Objective： To evaluate the effect of metformin on pregnancy outcomes in patients with polycystic ovary syndrome （PCOS） undergoing in vitro fertilization/intracytoplasmic sperm injection （IVF/ ICSI）, so as to provide evidence for clinical interventions. Methods： Randomized controlled trials （RCTs）, which focus on the comparison of pregnancy outcomes in PCOS patients undergoing IVF/ICSI were search. Literatures were collected from China National Knowledge Infrastructure （CNKI）, Wanfang database, VIP Information, Pubmed, Medline and Embase database. Quality assessment and data extraction were performed independently by two investigators and were analyzed by RevMan 5.2. Results： Eleven literatures involving 1 310 cases were selected for Meta analysis, of which 713 cases were in metformin group while the other 597 cases were in control group. Meta analysis showed that the pregnancy rate （OR=1.60, 95%CI=1.26-2.04, P=0.000 2） was higher, ovarian hyperstimulation syndrome （OHSS） rate （OR=0.45, 95%CI=0.31-0.64, P= 0.000 1） was lower in metformin group than in control group. But live birth rate （OR=1.38, 95%CI=0.98-1.94, P=0.06） and miscarriage rate （OR=0.72, 95%CI=0.51-1.02, P=0.07） were not significantly different between the two groups. Conclusion： Metformin can improve pregnancy rate, reduce OHSS rate, but it has no effects on improving live birth rate and reducing miscarriage rate in PCOS patients undergoing IVF/ICSI.

关 键 词：二甲双胍 体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSI.ET) 多囊卵巢综合征(PCOS) 妊娠结局 Meta分析 

分 类 号：R714.8[医药卫生—妇产科学] R711.75[医药卫生—临床医学]