激发方案的比较用于确定淋巴激素的剂量:基于随机对照试验的系统审查和贝叶斯网络元分析
Yangqin Peng1, Shujuan Ma1, Liang Hu1,2
1Reproductive and Genetic Hospital of CITIC-Xiangya, Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, China.
概括
与标准的COS相比,个人控制的卵巢刺激 (COS) 显著降低了卵巢过度刺激综合征 (OHSS) 和高反应的风险. 这种方法可能会稍微增加刺激时间,但提高了生育治疗的安全性.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 不孕症治疗方法 不孕症治疗方法
- 临床试验分析
背景情况:
- 对于个性化控制卵巢刺激 (COS) 与标准剂量COS有效性和安全性的证据有限.
- 现有的数据需要对个性化COS策略进行全面评估.
研究的目的:
- 通过随机对照试验 (RCT) 评估个人化COS疗效和安全的最新证据.
- 用生物标志物或临床经验来比较个性化COS与标准剂量COS.
主要方法:
- 系统搜索英语RCT,将个性化COS与标准剂量COS进行比较.
- 由两个独立审查员进行的资格评估,数据采用随机效应模型进行聚合.
- 对相对风险 (RRs) 和权重平均差异 (WMDs) 的元分析,使用95%的置信区间 (CI).
主要成果:
- 个体化COS显示卵巢过度刺激综合征 (OHSS) 的风险较低 (RR 0.66,95% CI:0.47-0.93).
- 个性化COS显著降低了对刺激的高反应 (RR 0.71,95%CI:0.57-0.90).
- 个性化COS (WMD 0.20,95%CI:0.01-0.40) 的卵巢刺激持续时间略长.
结论:
- 与标准的COS相比,个性化的COS显著降低了OHSS和超响应风险.
- 卵巢刺激的持续时间可以稍微延长个性化方法.
- 个性化COS为生育治疗提供了一个更安全的替代方案.
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