针对复发性胚胎植入失败的干预措施:一个总体审查
Abdulla Almohammadi1,2, Fadi Choucair1, Khalid S Khan2,3
1Reproductive Medicine Unit, Sidra Medicine, Doha, Qatar.
概括
复发性植入失败 (RIF) 干预措施显示出希望,特别是像G-CSF和PRP这样的免疫调节治疗. 然而,研究质量较低,需要谨慎地解释这些研究结果,以确定RIF治疗的有效性.
科学领域:
- 生殖医学和内分泌学.
- 不孕症研究 不孕症研究
- 系统性审查和元分析
背景情况:
- 复发性植入失败 (RIF) 是一个复杂的疾病,有多种促成因素.
- 现有的研究提出了各种干预措施来解决RIF.
- 进行了综合性审查,以综合这些干预措施的证据.
研究的目的:
- 总结和评估针对旨在治疗RIF的干预措施的证据的强度.
- 专注于随机临床试验 (RCT) 的系统审查 (SRs).
主要方法:
- 在Cochrane图书馆,Scopus和Medline数据库中进行系统搜索,直到2024年3月.
- 包括报告临床妊娠率 (CPR) 或活产率 (LBR) 的RCT的SRs.
- 使用AMSTAR 2评估的方法质量;使用GRADE评估的证据强度.
主要成果:
- 包括47个SR,主要侧重于免疫调节 (32) 和子宫/子宫内膜 (10) 的干预.
- 大多数SR (88%) 的方法质量极低或极低.
- 积极的元分析证据 (高中等级) 表明对G-CSF,脂内输液,PBMC,PRP,hCG,生长激素,LMWH,宫镜和子宫内膜损伤的有效性.
结论:
- 综合证据表明,免疫调节疗法 (G-CSF,PBMC,PRP,脂质内输液) 和对RIF的子宫内膜损伤的潜在有效性.
- 由于包含的SRs的方法质量普遍较低和临床异质性,研究结果应谨慎解释.
- 需要进一步的高质量的RCT来确认这些RIF干预措施的有效性.
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