TEAS,DHEA,CoQ10和GH用于接受IVF-ET的卵巢反应差:系统性审查和网络元分析
Fengya Zhu1,2, Shao Yin3, Bin Yang1
1Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Reproductive biology and endocrinology : RB&E
|July 18, 2023
概括
辅酶Q10 (CoQ10) 和脱水氨 (DHEA) 补充剂改善了在体外受精中接受卵巢反应不良 (POR) 的妇女的怀孕结果. 增长激素 (GH) 也显示出好处,而跨电针刺激 (TEAS) 则需要进一步调查.
科学领域:
- 生殖医学 生殖医学
- 不孕症治疗 不孕症治疗
- 基于证据的医学 基于证据的医学
背景情况:
- 辅助生殖技术 (ART) 面临着改善卵巢反应不良 (POR) 患者怀孕结果的挑战.
- 对于POR的辅助疗法的疗效仍然存在争议,需要严格的科学评估.
- 这项研究解决了对接受IVF-ET的POR患者辅助治疗的基于证据的建议的需求.
研究的目的:
- 系统地审查和网络元分析脱水氨 (DHEA),辅酶Q10 (CoQ10),生长激素 (GH) 和跨电针刺激 (TEAS) 对接受IVF-ET的POR患者怀孕结果的影响.
- 确定最佳的辅助治疗策略,以提高POR患者的IVF-ET成功率.
主要方法:
- 在多个数据库 (PubMed,Embase,Cochrane图书馆和中国数据库) 进行了系统的搜索,截至2022年7月30日.
- 包括随机对照试验 (RCT) 在POR患者中将辅助疗法 (DHEA,CoQ10,GH,TEAS) 与单独的受控卵巢刺激 (COS) 相比较.
- 网络元分析和累积排名曲线下的表面 (SUCRA) 用于评估治疗疗效.
主要成果:
- 与对照组相比,CoQ10和DHEA显著改善了POR患者的临床怀孕率.
- CoQ10在改善活产率方面表现出最高的有效性,而DHEA提高了胚胎植入率和高质量的胚胎率.
- GH显示好处,排名第二,而TEAS的有效性有限,尽管可能比没有辅助疗法更好.
结论:
- 在IVF-ET之前,辅助使用CoQ10,DHEA和GH显示出改善POR患者怀孕结果的临床益处.
- 对于TEAS在提高临床怀孕率方面的有效性,需要仔细考虑.
- 建议进一步进行直接比较的大规模RCT来验证这些发现.
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