重组人促卵泡激素对比尿促卵泡素在体外受精/卵胞质内单精子注射-胚胎移植中促排卵治疗的快速卫生技术评估  

Rapid Health Technology Assessment of Recombinant FSH versus Urine FSH in Ovulation Induction Therapy for in vitro Fertilization/intracytoplasmic Sperm Injection-embryo Transfer

作　　者：张若梅 吴斌[1] 金丽 ZHANG Ruomei;WU Bin;JIN Li(Dept.of Pharmacy,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China;Dept.of Pharmacy,International Peace Maternity and Child Health Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200030,China;Dept.of Infertility,International Peace Maternity and Child Health Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属仁济医院药剂科,上海200127 [2]上海交通大学医学院附属国际和平妇幼保健院药剂科,上海200030 [3]上海交通大学医学院附属国际和平妇幼保健院不孕不育科,上海200030

出　　处：《中国药房》2020年第22期2768-2773,共6页China Pharmacy

基　　金：国家自然科学基金资助项目(No.81871140)。

摘　　要：目的:比较重组人促卵泡激素(r FSH)和尿促卵泡素(u FSH)在体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)中促排卵治疗的有效性、安全性和经济性,为r FSH和uFSH的临床合理使用提供循证证据。方法:计算机检索PubMed、Embase、Cochrane图书馆、中国知网、维普网、万方数据以及专业的卫生技术评估(HTA)数据库,收集rFSH对比uFSH在IVF/ICSI-ET中促排卵治疗的HTA、系统评价/Meta分析和经济学研究。筛选文献、提取资料、评价质量后,采用定性描述的方法汇总纳入研究的结论。结果:共纳入7篇文献,包括2篇系统评价/Meta分析和5篇经济学评价,未检索到HTA报告,所有研究均来自国外报道。系统评价/Meta分析发现,rFSH组在控制性促排卵中的获卵数较u FSH组多;而两组的持续妊娠率、临床妊娠率、活产率、流产率和卵巢过度刺激综合征发生率比较差异均无统计学意义(P>0.05)。经济学研究显示,rFSH可能更具成本-效果优势。结论:目前可获得的证据支持将rFSH用于IVF/ICSI-ET的促排卵治疗,u FSH的疗效和安全性与其相当,且rFSH可能更具成本-效果优势。OBJECTIVE:To compare the efficacy,safety and economics of recombinant human follicle stimulating hormone(r FSH)and urin follicle stimulating hormone(u FSH)in the ovulation induction therapy for in vitro fertilization/intracytoplasmic sperm injection-embryo transfer,and to provide evidence-based evidence for rational use of r FSH in the clinic.METHODS:Retrieved from Pub Med,Embase,the Cochrane Library,CNKI,VIP,Wanfang database as well as professional health technology assessment(HTA)database,HTA,systematic review/Meta-analysis and economic studies were collected to compare the effects of r FSH versus urine FSH(u FSH)in ovulation induction for in vitro fertilization/intracytoplasmic sperm injectionembryo transfer(IVF/ICSI-ET).After literature screening,data extiaction and quality evaluation,the conclusions of the included studies were summarized by using qualitative description.RESULTS:A total of 7 literatures were included,involving 2 systematic reviews/Meta-analysis and 5 economic evaluations,and no HTA report was retrieved.All the studies were reported from abroad.Systematic evaluation/Meta-analysis showed that the number of oocytes obtained in the r FSH group was higher than that in the u FSH group.There was no statistical significance in persistent pregnancy rate,clinical pregnancy rate,live birth rate,abortion rate and the incidence of ovarian hyperstimulation syndrome(OHSS)between 2 groups(P>0.05).Economic research showed that r FSH may have cost-effective advantage.CONCLUSIONS:Current available evidence support that r FSH has simialr efficacy and safety for ovulation induction of IVF/ICSI-ET,and shows cost-effectiveness advantage.

关 键 词：重组人促卵泡激素 尿促卵泡素 快速卫生技术评估 体外受精/卵胞质内单精子注射-胚胎移植 促排卵治疗 疗效 安全性 经济性 

分 类 号：R956[医药卫生—药学]