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补充脱氢表雄酮(DHEA)对体外受精或卵胞浆内单精子注射的影响:一项随机对照试验的荟萃分析。

The Effect of Dehydroepiandrosterone (DHEA) Supplementation on IVF or ICSI: A Meta-Analysis of Randomized Controlled Trials.

作者信息

Xu Lin, Hu Chunxia, Liu Qun, Li Yaxuan

机构信息

Department of reproductive medicine, First Affiliated Hospital of Hainan Medical College, Haikou, Hainan 570102, China.

Department of Obstetrics, First Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570102, China.

出版信息

Geburtshilfe Frauenheilkd. 2019 Jul;79(7):705-712. doi: 10.1055/a-0882-3791. Epub 2019 Jul 10.

Abstract

A systematic review and meta-analysis were conducted to evaluate the efficacy of dehydroepiandrosterone (DHEA) supplementation in patients with diminished ovarian reserve (DOR) and/or poor ovarian response (POR) who were undergoing in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI). We searched the PubMed, EMBASE, Web of Science, and Cochrane Library electronic databases for literature published until July 2018. The analysis included randomized controlled trials (RCTs) of the effects of DHEA versus placebo on IVF or ICSI. Two independent reviewers extracted information from the reports and evaluated the quality of the studies. Overall, we identified nine prospective RCTs involving 833 patients. Compared to the controls, patients treated with DHEA exhibited increases in the number of retrieved oocytes (mean difference, 0.91; 95% confidence interval [CI], 0.23 - 1.59; p = 0.009), clinical pregnancy rate (relative risk [RR] = 1.27; 95% CI, 1.01 - 1.61; p = 0.04), and live birth rate (RR, 1.76; 95% CI, 1.17 - 2.63; p = 0.006). However, there was no intergroup difference in the miscarriage rate (RR, 0.37; 95% CI, 0.12 - 1.13; p = 0.08). DHEA supplementation improved the outcomes of IVF/ICSI in women with DOR or POR.

摘要

进行了一项系统评价和荟萃分析,以评估补充脱氢表雄酮(DHEA)对正在接受体外受精或卵胞浆内单精子注射(IVF/ICSI)的卵巢储备功能减退(DOR)和/或卵巢反应不良(POR)患者的疗效。我们检索了截至2018年7月发表的文献的PubMed、EMBASE、科学网和Cochrane图书馆电子数据库。该分析包括DHEA与安慰剂对IVF或ICSI影响的随机对照试验(RCT)。两名独立的评审员从报告中提取信息并评估研究质量。总体而言,我们确定了9项涉及833名患者的前瞻性RCT。与对照组相比,接受DHEA治疗的患者回收的卵母细胞数量增加(平均差异,0.91;95%置信区间[CI],0.23 - 1.59;p = 0.009),临床妊娠率(相对风险[RR] = 1.27;95% CI,1.01 - 1.61;p = 0.04)和活产率(RR,1.76;95% CI,1.17 - 2.63;p = 0.006)。然而,流产率在组间没有差异(RR,0.37;95% CI,0.12 - 1.13;p = 0.08)。补充DHEA改善了DOR或POR女性的IVF/ICSI结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7147/6620181/1190d2616738/10-1055-a-0882-3791-igf01.jpg

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