促性腺激素释放激素激动剂添加黄体支持对体外受精/卵胞浆内单精子注射周期妊娠结局的影响：基于随机对照试验的荟萃分析。
Effect of Gonadotrophin-Releasing Hormone Agonist Addition for Luteal Support on Pregnancy Outcome in vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: A Meta-Analysis Based on Randomized Controlled Trials.
机构信息
The Reproductive Medicine Special Hospital, The First Hospital of Lanzhou University, Lanzhou, China.
Key Laboratory for Reproductive Medicine and Embryo, The First Hospital of Lanzhou University, Lanzhou, China.
出版信息
Gynecol Obstet Invest. 2020;85(1):13-25. doi: 10.1159/000501204. Epub 2019 Aug 16.
PURPOSE
The meta-analysis aimed to evaluate the effect of gonadotrophin-releasing hormone agonist (GnRH-a) addition for luteal support on pregnancy outcome in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles.
METHODS
Meta-analysis.
RESULTS
A total of 3,584 cycles were identified from 13 randomized controlled trials. The cumulative analysis showed that GnRH-a addition for luteal supports significantly improved live birth rate (relative risk [RR] = 1.52; 95% CI 1.20-1.94; p = 0.0006), the clinical pregnancy rate (RR 1.21; 95% CI 1.11-1.33; p < 0.0001), ongoing pregnancy rate (RR 1.18; 95% CI 1.06-1.32; p = 0.004), pregnancy rate (RR 1.36; 95% CI 1.01-1.82; p = 0.04), implantation rate (RR 1.44; 95% CI 1.17-1.77; p = 0.0007), and multiple pregnancy rate (RR 1.40; 95% CI 1.04-1.88; p = 0.03) in comparison with control, but not for the incidence of ovarian hyperstimulation syndrome (RR 0.96; 95% CI 0.32-2.89; p = 0.94). We also found that GnRH-a addition for luteal support had a tendency to decrease the abortion rate (RR 0.72; 95% CI 0.56-0.93; p = 0.01).
CONCLUSIONS
Overall, the current meta-analysis showed a substantial efficacy of GnRH-a addition for luteal support on pregnancy outcomes in women undergoing IVF/ICSI and support the use of GnRH-a in luteal phase to improve the success of IVF/ICSI.
目的
本荟萃分析旨在评估在体外受精（IVF）/卵胞浆内单精子注射（ICSI）周期中添加促性腺激素释放激素激动剂（GnRH-a）进行黄体支持对妊娠结局的影响。
方法
荟萃分析。
结果
从 13 项随机对照试验中确定了 3584 个周期。累积分析表明，GnRH-a 黄体支持显著提高活产率（相对风险 [RR] 1.52；95%置信区间 1.20-1.94；p = 0.0006）、临床妊娠率（RR 1.21；95%置信区间 1.11-1.33；p < 0.0001）、持续妊娠率（RR 1.18；95%置信区间 1.06-1.32；p = 0.004）、妊娠率（RR 1.36；95%置信区间 1.01-1.82；p = 0.04）、着床率（RR 1.44；95%置信区间 1.17-1.77；p = 0.0007）和多胎妊娠率（RR 1.40；95%置信区间 1.04-1.88；p = 0.03），与对照组相比，但卵巢过度刺激综合征的发生率无差异（RR 0.96；95%置信区间 0.32-2.89；p = 0.94）。我们还发现，添加 GnRH-a 进行黄体支持有降低流产率的趋势（RR 0.72；95%置信区间 0.56-0.93；p = 0.01）。
结论
总的来说，本荟萃分析表明 GnRH-a 黄体支持对接受 IVF/ICSI 的女性妊娠结局有显著疗效，并支持在黄体期使用 GnRH-a 提高 IVF/ICSI 的成功率。
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