辅助生殖技术中的孕激素水平:系统审查和元分析
Yee Cherng Lim1,2, Mukhri Hamdan2, Abha Maheshwari3
1Complete Fertility, Princess Anne Hospital, Level F, Coxford Road, Southampton, SO16 5YA, UK.
Scientific reports
|December 27, 2024
概括
在新鲜的试管婴儿周期中,孕激素 (EP) 的升高不会影响基线活产率 (LBR). 然而,在排卵触发时的EP与第3天胚胎移植的较低LBR有关,但在第5天胚胎移植中并非如此.
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:
- 孕激素水平在ART周期中至关重要,孕激素 (EP) 升高或不充分的水平可能会影响结果.
- 管理EP的临床实践各不相同,其对妊娠成功的影响仍在争论中.
- 了解孕激素的作用是优化试管婴儿/ICSI协议和提高活产率 (LBR) 的关键.
研究的目的:
- 系统地审查和分析新鲜和冷ART周期期间孕激素水平对怀孕结果的影响.
- 具体研究不同时间点的EP与LBR之间的关联,考虑第3天与第5天的胚胎移植.
- 评估孕激素水平对临床怀孕率 (CPR),持续怀孕率 (OPR) 和流产率 (MR) 的影响.
主要方法:
- 在主要数据库 (EMBASE,MEDLINE,PubMed等) 中进行系统的文献搜索. 在2000年以后的研究中.
- 包括关于新鲜和冷试管婴儿/ICSI周期的研究,以及可用的血清孕激素和怀孕结果数据.
- 使用RevMan5和DerSimonian和Laird随机效应模型进行元分析;使用纽卡斯尔-太华尺度 (NOS) 评估偏差风险.
主要成果:
- 在新鲜循环中,基线时的EP并没有显著影响LBR或CPR.
- 在排卵触发时的EP与第3天胚胎移植的显著较低的LBR和CPR有关.
- 然而,在排卵触发时的EP并没有对第5天胚胎移植的LBR或CPR产生显著影响.
结论:
- 在新的ART周期的受控卵巢刺激中,基线EP不会影响LBR.
- 在排卵触发时的EP与第3天胚胎移植中的LBR减少有关,但在第5天胚胎移植中并非如此.
- 由于显著的异质性,冷胚胎移植 (FET) 周期的数据无法进行有意义的元分析.
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