体外受精-胚胎移植反复种植失败影响因素的Meta分析  

Influencing factors for repeated implantation failure after in vitro fertilization-embryo transfer:a meta-analysis

作　　者：牛金枝 吴晓煜 宁艳娇[2] 冯亚静 单伟颖 NIU Jinzhi;WU Xiaoyu;NING Yanjiao;FENG Yajing;SHAN Weiying(School of Nursing,Hebei University of Chinese Medicine,Shijiazhuang,Hebei 050091,China;Chengde Nursing Vocational College,Chengde,Hebei 067000,China)

机构地区：[1]河北中医药大学护理学院,河北石家庄050091 [2]承德护理职业学院,河北承德067000

出　　处：《预防医学》2025年第3期237-242,共6页China Preventive Medicine Journal

基　　金：承德市科技计划项目(202205B083)。

摘　　要：目的系统评价中国体外受精-胚胎移植(IVF-ET)反复种植失败(RIF)的影响因素,为RIF预防提供循证依据。方法系统检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库、中国医学文献服务系统、PubMed、Web of Science、Cochrane Library和Embase数据库,收集建库至2024年9月发表的关于中国IVF-ET RIF影响因素的文献。采用RevMan 5.3和Stata 14.0软件进行Meta分析;逐一剔除文献进行敏感性分析;采用Egger检验评价发表偏倚。结果检索相关文献4836篇,最终纳入12篇,总样本量为11554例,其中病例对照研究10篇,队列研究1篇,横断面研究1篇;高质量文献10篇,中等质量文献2篇。Meta分析结果显示,年龄大(OR=1.121,95%CI:1.035~1.215)、不孕年限长(OR=1.237,95%CI:1.091~1.403)、宫腔镜检查结果异常(OR=2.205,95%CI:1.119~4.348)、抗核抗体(ANA)阳性(OR=2.393,95%CI:1.473~3.886)、抗β2-糖蛋白Ⅰ抗体(β2-GPⅠ-Ab)阳性(OR=2.824,95%CI:1.987~4.013)与RIF风险升高有关;移植胚胎数量多(OR=0.309,95%CI:0.098~0.973)、子宫内膜厚(OR=0.601,95%CI:0.556~0.650)、粒细胞集落刺激因子(G-CSF)水平高(OR=0.657,95%CI:0.511~0.845)与RIF风险降低有关。结论IVF-ET RIF与年龄、不孕年限、移植胚胎数量、子宫内膜、宫腔镜检查结果、G-CSF水平、ANA和β2-GPⅠ-Ab有关。Objective To systematically evaluate the influencing factors for repeated implantation failure(RIF)after in vitro fertilization-embryo transfer(IVF-ET)in China,so as to provide the evidence for prevention of RIF.Methods Literature on influencing factors for RIF in China were retrieved from CNKI,Wanfang Data,VIP,China Medical Literature Service System,PubMed,Web of Science,Cochrane Library and Embase from inception to September,2024.A metaanalysis was performed using RevMan 5.3 and Stata 14.0 softwares.Literature were excluded one by one for sensitivity analysis.Publication bias was evaluated using Egger's test.Results Initially 4836 relevant articles were retrieved,and 12 of them were finally included,with a total sample size of 11554 individuals.There were 10 case-control studies,1 cohort study,and 1 cross-sectional study;and 10 high-quality studies and 2 medium-quality studies.The meta-analysis showed that factors including advanced age(OR=1.121,95%CI:1.035-1.215),prolonged infertility duration(OR=1.237,95%CI:1.091-1.403),abnormal hysteroscopy findings(OR=2.205,95%CI:1.119-4.348),positive anti-nuclear antibody(ANA)(OR=2.393,95%CI:1.473-3.886),and positive anti-beta2 glycoproteinⅠantibody(β2-GPⅠ-Ab)(OR=2.824,95%CI:1.987-4.013)were associated with an increased risk of RIF;while factors including the large number of embryos transferred(OR=0.309,95%CI:0.098-0.973),thicker endometrium(OR=0.601,95%CI:0.556-0.650),and higher granulocyte colony-stimulating factor(G-CSF)levels(OR=0.657,95%CI:0.511-0.845)were associated with a reduced risk of RIF.Conclusion IVF-ET RIF is associated with age,infertility duration,number of embryos transferred,endometrial thickness,hysteroscopy findings,G-CSF levels,ANA andβ2-GPⅠ-Ab.

关 键 词：反复种植失败 影响因素 META分析 

分 类 号：R321.3[医药卫生—人体解剖和组织胚胎学]