在新鲜的试管婴儿/ICSI周期中比较质支持方案:一个网络的元分析
Stavroula L Kastora1,2, Grigoria Gkova3, Konstantinos Stavridis4
1UCL EGA Institute for Women's Health, University College London, Medical School Building, Room G15, 86-96 Chenies Mews, 74 Huntley Street, London, WC1E 6HX, UK. s.kastora@ucl.ac.uk.
Scientific reports
|June 24, 2024
概括
这项研究比较了体外受精 (IVF) 的叶阶段支持 (LPS) 协议. 包括阴道孕激素加上皮下GnRH激动剂在内的组合显著改善了活产率和减少流产.
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:
- 乳腺期支持 (LPS) 协议对于改善IVF和ICSI周期中的怀孕率至关重要.
- 尽管已证明有好处,但最佳的LPS选择,剂量和持续时间仍在争论中.
- 这项研究通过评估基于关键ART成功指标的LPS协议来解决这一争议.
研究的目的:
- 为了确定最佳的质期支持 (LPS) 协议,以获得辅助生殖技术 (ART) 的成功.
- 根据主要结果比较LPS协议:临床怀孕和活产.
- 评估二次结果,包括生化妊娠,流产,多胎妊娠和卵巢过度刺激综合征 (OHSS).
主要方法:
- 贝叶斯网络元分析 (NMA) 进行,包括76个随机对照试验 (RCT) 与26,536名参与者.
- 阴道孕激素 (VP) 作为参考干预措施.
- 结果使用固定效应模型进行分析,呈现 95% 可信度区间 (CrIs) 的几率比率 (ORs).
主要成果:
- 阴道孕激素 (VP) 与口服雌激素 (OE) 和皮下GnRH激动剂 (SCGnRH-a) 的联合疗法改善了临床怀孕率.
- VP + SCGnRH-a显著减少了流产事件 (或0.54).
- VP + SCGnRH-a在长期和短期卵巢刺激方案中出现了最佳的LPS,增强活产并减少流产和OHSS.
结论:
- 结合性LPS治疗,特别是那些将SCGnRH-a添加到VP基础的治疗,在GnRH-激动剂和对抗剂卵巢刺激方案中提高了临床怀孕和活产率.
- 建议使用VP+SCGnRH-a协议来优化ART的结果,考虑到它对活产,流产减少和OHSS预防的好处.
- 进一步的研究可能会完善个性化LPS策略的特定剂量和持续时间.
关键词:
临床怀孕 临床怀孕生育能力 生育能力 生育能力活生生的出生是活生生的出生.体支持 体支持流产 流产 流产多重怀孕是多重怀孕的情况.网络元分析 网络元分析这是OHSS的原因.孕激素 (Progesterone) 是一种激素.更多相关视频
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