无法解释的不孕不育的定义:一个系统的审查
Claudia Raperport1, Jessica Desai2, Danya Qureshi3
1Women's Health Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
BJOG : an international journal of obstetrics and gynaecology
|November 13, 2023
概括
缺乏对不明原因不孕症的标准化诊断标准,导致研究偏见. 本次审查提出了统一的标准,以提高研究质量和对面临不孕症的夫妇的临床护理.
科学领域:
- 生殖医学 生殖医学
- 不孕症研究 不孕症研究
- 临床诊断 临床诊断 临床诊断
背景情况:
- 无法解释不育症的不一致的诊断标准阻碍了研究和临床实践.
- 研究群体中的异质性引入了偏见,影响了元分析和基于证据的建议.
- 目前的诊断方法缺乏统一的标准,影响研究结果的可靠性.
研究的目的:
- 系统地审查和分析不解释不育症研究的纳入标准的变化.
- 为无法解释的不孕症提出标准化的诊断和研究标准.
- 提高未来研究和不孕症临床管理的质量.
主要方法:
- 在CINAHL和MEDLINE数据库中发表的研究的系统审查,截至2022年11月.
- 包括全文英语研究,招募有不明原因不孕症的夫妇.
- 将数据提取到Excel电子表格,并按类别,方法和参考范围进行分析.
主要成果:
- 在375项研究中,258项定义了纳入标准;精液分析 (85%),输卵管通透度 (90%) 和排卵评估 (79.5%) 是最常见的.
- 观察到显著的变化:只有39.5%的精液分析使用了世卫组织的限值;输卵管通透度的定义有所不同;排卵评估方法不同 (孕激素与周期史).
- 不到50%的研究包括子宫腔评估或激素配置文件,突出了广泛的不一致性.
结论:
- 该审查证实,在研究不明原因不孕症的人群中存在显著的异质性.
- 实施国际公认的标准化标准对于提高研究完整性至关重要.
- 标准化标准将提高未来研究的质量,并为不育夫妇提供先进的临床护理.
相关概念视频
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