雌激素 (脱乙或) 对于接受辅助生殖的女性
Sandeep Naik1, Sam Lepine2, Helen E Nagels3
1Obstetrics and Gynaecology, Capital Coast District Heath Board, Wellington, New Zealand.
The Cochrane database of systematic reviews
|June 5, 2024
概括
(T) 前期治疗可能会改善体外受精 (IVF) 妇女的活产率,而脱水素 (DHEA) 几乎没有差异. 这两种激素可能不会降低流产率,但它们对多胎妊娠的影响尚不确定.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 辅助生殖技术 (ART) 是一种辅助生殖技术.
背景情况:
- 医生寻求辅助治疗以提高ART的结果.
- 脱水氨 (DHEA) 和 (T) 正在研究它们通过增强卵泡对淋巴激素的反应来提高受孕率的潜力.
- 这可能会导致卵细胞产量增加和更高的怀孕机会.
研究的目的:
- 评估DHEA和T的有效性和安全性,作为在接受辅助生殖的不孕妇女的前或同时治疗.
主要方法:
- 对28项随机对照试验 (RCT) 的系统审查,涉及干预组的1533名妇女和对照组的1469名妇女.
- 试验将DHEA或T辅助治疗与安慰剂或没有治疗进行了比较,主要是在被确定为IVF"反应不佳"的女性中进行的.
- 数据使用固定效应模型进行了聚合,结果使用几率比率 (ORs) 进行分析,确定性通过GRADE方法进行评估.
主要成果:
- 在DHEA治疗前,活产/正在进行的怀孕率 (OR 1.30) 和临床怀孕率 (OR 1.18) 的差异很小或没有差异,有中等确定性证据.
- 用T的预治疗可能改善了活产率 (OR 2.53) 和临床怀孕率 (OR 2.17),证据中等确定性.
- 无论是DHEA还是T都没有显著降低流产率,并且由于证据确定性非常低,对多胎妊娠的影响是不确定的.
结论:
- 前治疗可能会改善对IVF反应较差患者的活产和临床怀孕率.
- 脱水龙前期治疗可能导致这些结果几乎没有差异.
- 需要进一步研究最佳的T治疗持续时间和不良事件/多胎妊娠数据收集.
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