Kim Seul Ki, Han E-Jung, Kim Sun Mie, Lee Jung Ryeol, Jee Byung Chul, Suh Chang Suk, Kim Seok Hyun
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
Clin Exp Reprod Med. 2016 Dec;43(4):233-239. doi: 10.5653/cerm.2016.43.4.233. Epub 2016 Dec 26.
Uterine contraction induced by the embryo transfer (ET) process has an adverse effect on embryo implantation. The aim of this study was to determine the effect of oxytocin antagonist supplementation on the day of ET on fertilization outcomes via a meta-analysis.
We performed a meta-analysis of randomized controlled trials (RCTs). Four online databases (Embase, Medline, PubMed, and Cochrane Library) were searched through May 2015 for RCTs that investigated oxytocin antagonist supplementation on the day of ET. Studies were selected according to predefined inclusion criteria and meta-analyzed using RevMan 5.3. Only RCTs were included in this study. The main outcome measures were the clinical pregnancy rate, the implantation rate, and the miscarriage rate.
A total of 123 studies were reviewed and assessed for eligibility. Three RCTs, which included 1,020 patients, met the selection criteria. The implantation rate was significantly better in patients who underwent oxytocin antagonist infusion (19.8%) than in the control group (11.3%) (n=681; odds ratio [OR], 1.92; 95% confidence interval [CI], 1.25-2.96). No significant difference was found between the two groups in the clinical pregnancy rate (n=1,020; OR, 1.57; 95% CI, 0.92-2.67) or the miscarriage rate (n=456; OR, 0.76; 95% CI, 0.44-1.33).
The results of this meta-analysis of the currently available literature suggest that the administration of an oxytocin antagonist on the day of ET improves the implantation rate but not the clinical pregnancy rate or miscarriage rate. Additional, large-scale, prospective, randomized studies are necessary to confirm these findings.
胚胎移植（ET）过程引发的子宫收缩对胚胎着床有不利影响。本研究旨在通过荟萃分析确定ET当天补充催产素拮抗剂对受精结局的影响。
我们对随机对照试验（RCT）进行了荟萃分析。通过检索截至2015年5月的四个在线数据库（Embase、Medline、PubMed和Cochrane图书馆），查找研究ET当天补充催产素拮抗剂的RCT。根据预先设定的纳入标准选择研究，并使用RevMan 5.3进行荟萃分析。本研究仅纳入RCT。主要结局指标为临床妊娠率、着床率和流产率。
共审查和评估了123项研究的 eligibility。三项RCT（包括1020例患者）符合选择标准。接受催产素拮抗剂输注的患者的着床率（19.8%）显著高于对照组（11.3%）（n = 681；优势比[OR]，1.92；95%置信区间[CI]，1.25 - 2.96）。两组在临床妊娠率（n = 1020；OR，1.57；95% CI，0.92 - 2.67）或流产率（n = 456；OR，0.76；95% CI，(0.44 - 1.33)）方面未发现显著差异。
对现有文献的这项荟萃分析结果表明，ET当天给予催产素拮抗剂可提高着床率，但不能提高临床妊娠率或降低流产率。需要更多大规模、前瞻性、随机研究来证实这些发现。
