Wang Liping, Huang Xiaman, Li Xueli, Lv Fang, He Xiao, Pan Yu, Wang Li, Zhang Xiaomei
Department of Biobank, Clinical Medical College,Yangzhou University, Northern Jiangsu Province Hospital, Yangzhou Department of Obstetrical, the First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Reproductive Medicine Center, Department of Obstetrics and Gynecology, Clinical Medical College, Yangzhou University, Northern Jiangsu Province Hospital, Yangzhou, China The University of Texas MD Anderson Cancer Center, Department of Anesthesiology & Perioperative Medicine, Houston, TX.
Medicine (Baltimore). 2017 Sep;96(37):e7720. doi: 10.1097/MD.0000000000007720.
We conducted a systematic review and meta-analysis of existing literature to evaluate the different outcomes of low-dose aspirin on patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), including clinical pregnancy rate, implantation rate, live birth rate, miscarriage rate, fertilization rate, number of oocytes retrieved, and so forth.
Electronic databases including PubMed, MEDLINE, and Embase were searched between 1997 and March 2016 to identity eligible studies. The following comparisons between treatment groups were included: aspirin versus placebo; aspirin versus control group; aspirin versus aspirin + prednisolone + control.
Thirteen randomized controlled trials which included 3104 participants were selected. There were no significant differences in implantation rate (RR = 1.15; 95% CI = 0.78-1.70), live birth rate (RR = 1.06; 95% CI = 0.93-1.21), miscarriage rate (RR = 1.28; 95% CI = 0.93-1.77), fertilization rate (RR = 0.91; 95% CI = 0.75-1.11), and endometrial thickness (WMD = 0.15; 95% CI = -0.38-0.67). But the research showed that aspirin treatment may improve the clinical pregnancy rate (RR = 1.16; 95% CI = 1.04-1.28) compared to placebo or no treatment, and reduce the number of oocytes retrieved (WMD = -0.68; 95% CI = -0.91-0.46).
Our findings suggest that low-dose aspirin may improve the pregnancy rate in IVF/ICSI, with the recommended clinical use dose of 100 mg/day. Considering the limitation of included studies, further well-designed large-scaled RCTs are necessary to clarify whether aspirin may improve assisted reproduction outcomes in IVF/ICSI patients.
我们对现有文献进行了系统评价和荟萃分析，以评估低剂量阿司匹林对接受体外受精（IVF）/卵胞浆内单精子注射（ICSI）的患者的不同结局，包括临床妊娠率、着床率、活产率、流产率、受精率、获卵数等。
检索了1997年至2016年3月期间的电子数据库，包括PubMed、MEDLINE和Embase，以确定符合条件的研究。纳入了治疗组之间的以下比较：阿司匹林与安慰剂；阿司匹林与对照组；阿司匹林与阿司匹林+泼尼松龙+对照组。
选择了13项随机对照试验，共3104名参与者。着床率（RR = 1.15；95%CI = 0.78 - 1.70）、活产率（RR = 1.06；95%CI = 0.93 - 1.21）、流产率（RR = 1.28；95%CI = 0.93 - 1.77）、受精率（RR = 0.91；95%CI = 0.75 - 1.11）和子宫内膜厚度（WMD = 0.15；95%CI = -0.38 - 0.67）无显著差异。但研究表明，与安慰剂或未治疗相比，阿司匹林治疗可能提高临床妊娠率（RR = 1.16；95%CI = 1.04 - 1.28），并减少获卵数（WMD = -0.68；95%CI = -0.91 - 0.46）。
我们的研究结果表明，低剂量阿司匹林可能提高IVF/ICSI的妊娠率，推荐临床使用剂量为100mg/天。考虑到纳入研究的局限性，有必要进行进一步设计良好的大规模随机对照试验，以阐明阿司匹林是否可改善IVF/ICSI患者的辅助生殖结局。
