在非生育性夫妇的子宫内授精的同步方法
Melody Adesina1, Astrid Ep Cantineau2, Marian G Showell3
1School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, UK.
The Cochrane database of systematic reviews
|September 23, 2025
概括
这次审查发现,没有足够的证据来确定子宫内授精 (IUI) 的最佳时间,以最大限度地提高活产率. 需要进一步的研究来澄清在IUI周期中不同排卵监测和触发方法的有效性.
科学领域:
- 生殖医学 生殖医学
- 不孕症治疗 不孕症治疗
- 基于证据的医学基于证据的医学.
背景情况:
- 宫内授精 (IUI) 是一种常见的低生育率的第一线治疗方法.
- 使用IUI的怀孕率差异很大,最佳时机策略尚不清楚.
- 这次审查更新了2014年之前的Cochrane审查.
研究的目的:
- 评估不同方法的有效性,以同步授精与排卵.
- 评估自然和刺激IUI周期中的活产和临床怀孕率等结果.
- 确定IUI的最佳时间方法和排卵监测/触发技术.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了多个数据库,直到2023年10月,包括Cochrane妇科和生育组注册,CENTRAL和MEDLINE.
- 包括42项研究 (6603对夫妇),比较各种计时方法,排卵检测 (LH,超声波,BBT) 和触发剂 (hCG,GnRH激动剂).
主要成果:
- 大多数比较的证据确定性很低,主要是由于不准确.
- 在比较从hCG注射到IUI (0-33小时 vs. 34-40小时 vs. >40小时) 的不同时间间隔时,没有发现活产或持续怀孕率的明显差异.
- 与hCG加FSH相比,仅使用hCG的活产率可能较低,但证据的确定性较低.
结论:
- 没有足够的证据来推IUI中与排卵同步授精的特定方法.
- 不同的计时策略和排卵触发方法的有效性需要进一步研究.
- 需要更多高质量的RCT来提供关于优化IUI时间以改善妊娠结果的最终指导.
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