Department of Obstetrics and Gynecology, The West China Second University Hospital, University of Sichuan, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, 20 Renmin Nanlu Road, Chengdu, 610041, People's Republic of China.
J Assist Reprod Genet. 2017 Nov;34(11):1559-1565. doi: 10.1007/s10815-017-0994-3. Epub 2017 Jul 13.
The human leucocyte antigen-G (HLA-G) 14-bp insertion/deletion polymorphism was implicated in recurrent implantation failure (RIF), but individual published studies showed inconclusive results. Thus, a meta-analysis was performed to clarify the effect of HLA-G 14-bp polymorphism on RIF risk.
A comprehensive search for relevant articles was conducted. The odds ratios (ORs) and 95% confidence intervals (CIs) for HLA-G 14-bp polymorphism and RIF were calculated.
A total of five studies were included. In studies conducted in RIF patients and controls who had at least one spontaneous pregnancy, meta-analysis revealed no statistically significant association between the HLA-G 14-bp polymorphism and RIF in allele contrast and all genetic models in the overall population, but significant association was found in the population of Caucasian origin under allele contrast (OR = 1.73, 95% CI, 1.20, 2.50) and genetic models of +14 bp/+14 bp vs. -14 bp/-14 bp (OR = 3.09, 95% CI, 1.43, 6.65). In studies conducted in RIF patients and controls who had successful pregnancy following IVF-ET, the meta-analysis showed that there was statistically significant association between the HLA-G 14 bp polymorphism and RIF in allele contrast (OR = 1.74, 95% CI, 1.13, 2.67) and genetic models of +14 bp/+14 bp vs. -14 bp/-14 bp (OR = 10.20, 95% CI, 2.47, 42.14) and dominant model (OR = 4.34, 95% CI, 1.72, 10.92). No publication bias was found in the present studies.
This meta-analysis suggested that the HLA-G 14-bp insertion allele may increase the risk of RIF in Caucasians. Further studies with large sample size of different ethnic populations are necessary.
人类白细胞抗原-G（HLA-G）14 位核苷酸插入/缺失多态性与复发性植入失败（RIF）有关，但个别已发表的研究结果尚无定论。因此，进行了荟萃分析以阐明 HLA-G 14 位核苷酸多态性对 RIF 风险的影响。
全面检索相关文献。计算 HLA-G 14 位核苷酸多态性与 RIF 相关的优势比（OR）和 95%置信区间（CI）。
共纳入 5 项研究。在对至少有一次自然妊娠的 RIF 患者和对照者进行的研究中，荟萃分析显示，在总体人群中，等位基因对比和所有遗传模型均未发现 HLA-G 14 位核苷酸多态性与 RIF 之间存在统计学显著关联，但在白种人群中发现存在关联等位基因对比（OR=1.73，95%CI，1.20，2.50）和 +14bp/+14bp 与-14bp/-14bp （OR=3.09，95%CI，1.43，6.65）遗传模型。在对接受 IVF-ET 后成功妊娠的 RIF 患者和对照者进行的研究中，荟萃分析显示，在等位基因对比（OR=1.74，95%CI，1.13，2.67）和 +14bp/+14bp 与-14bp/-14bp （OR=10.20，95%CI，2.47，42.14）和显性模型（OR=4.34，95%CI，1.72，10.92）中，HLA-G 14 位核苷酸多态性与 RIF 之间存在统计学显著关联。本研究未发现发表偏倚。
本荟萃分析表明，HLA-G 14 位核苷酸插入等位基因可能增加白种人群 RIF 的风险。需要对不同种族人群进行更大样本量的进一步研究。
