在患有多囊性卵巢综合征的妇女中,用于诱导排卵的淋巴激素
Nienke S Weiss1, Elena B Kostova2, Ben Willem J Mol3
1Gynaecology and Obstetrics, Amstelland Hospital, Amstelveen, Netherlands.
The Cochrane database of systematic reviews
|April 7, 2025
概括
对于对克洛米芬酸盐或莱特醇无反应的PCOS妇女来说,相比继续使用克洛米芬酸盐,淋巴激素 (FSH) 可能会增加活产和临床怀孕,而不会增加多胎妊娠率.
科学领域:
- 生殖内分泌学和不孕不育问题
- 妇科 妇科 妇科 妇科
- 临床试验和证据综合
背景情况:
- 多囊性卵巢综合征 (PCOS) 是无卵性不孕症的常见原因之一.
- 排卵诱导是PCOS相关不孕症的关键治疗方法.
- 卵泡刺激激素 (FSH) 是对女性的第二线治疗PCOS谁不响应口服药物,如克洛米芬酸盐或莱特.
研究的目的:
- 为了比较不同性腺激素在PCOS妇女的排卵诱导中的有效性和安全性.
- 在克洛米芬酸盐或莱特醇失败后,评估淋巴激素作为二线治疗.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 包括的研究比较了复合FSH (rFSH),人更年期性淋巴激素 (HMG),纯化尿液FSH (uFSH) 和高度纯化的FSH (HP-FSH).
- 评估的结果包括活产率,多胎妊娠率,临床妊娠,流产,宫外妊娠和卵巢过度刺激综合征 (OHSS).
主要成果:
- 再组合FSH (rFSH) 与尿源性淋巴激素 (低确定性证据) 相比,活产,多胎妊娠或临床妊娠率几乎没有差异.
- 人类绝经性淋巴激素 (HMG) 与纯化尿液FSH (uFSH) 相比,由于证据确定性非常低,大多数结果的结果不确定.
- 与继续使用克洛米芬酸盐相比,淋巴激素 (FSH) 可能会增加活产和临床怀孕,并可能增加流产率 (中等确定性证据).
结论:
- 淋巴激素,特别是FSH,可能比持续使用克洛米芬酸盐更有效,在初始治疗失败的PCOS妇女中实现活产.
- 比较不同类型的淋巴激素 (rFSH,HMG,uFSH) 的证据确定性低至非常低,因此很难得出明确的结论.
- 需要进一步进行高质量的RCT,以澄清PCOS排卵诱导中的各种淋巴激素制剂的比较有效性和安全性.
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