探讨宫内注射人绒毛膜促性腺激素以改善试管婴儿结局的最佳时间：系统评价和荟萃分析。
Investigating the Optimal Time for Intrauterine Human Chorionic Gonadotropin Infusion in Order to Improve IVF Outcome: A Systematic Review and Meta-Analysis.
机构信息
Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Centre for Human Reproduction, Genesis Athens Clinic, Athens, Greece.
出版信息
In Vivo. 2019 Nov-Dec;33(6):1737-1749. doi: 10.21873/invivo.11664.
BACKGROUND/AIM: Studies on the impact of intrauterine human Chorionic Gonadotropin (hCG) administration in order to improve the In Vitro Fertilization (IVF) outcome have yielded conflicting results. The aim of the present systematic review and meta-analysis is to investigate whether timing of intrauterine hCG administration prior to embryo transfer affects its efficiency.
MATERIALS AND METHODS
A systematic search of the literature on Pubmed/Medline, Embase and Cochrane databases was performed. Only Randomized Control Trials were included in this meta-analysis.
RESULTS
Live birth rates were not improved following hCG administration (RR=1.13, 95%CI=0.88-1.46, p=0.34) in the pooled results. Combined live birth and ongoing pregnancy rates were borderline statistically significant following hCG administration (RR=1.27, 95%CI=1.00-1.62, p=0.05). Following subgroup analysis regarding live birth and ongoing pregnancy rates, only the 5-12 minutes prior to the embryo transfer group reported a statistically significant improvement.
CONCLUSION
Intrauterine infusion of hCG within an IVF-Intracytoplasmic Sperm Injection (ICSI) cycle improves outcome only when administered 5-12 min prior to embryo transfer.
背景/目的：研究宫内注射人绒毛膜促性腺激素（hCG）以改善体外受精（IVF）结局的影响的研究结果相互矛盾。本系统评价和荟萃分析的目的是调查胚胎移植前宫内注射 hCG 的时间是否会影响其效率。
材料和方法
对 Pubmed/Medline、Embase 和 Cochrane 数据库进行了系统的文献搜索。只有随机对照试验被纳入本荟萃分析。
结果
在汇总结果中，hCG 给药后活产率没有提高（RR=1.13，95%CI=0.88-1.46，p=0.34）。hCG 给药后联合活产和持续妊娠率具有统计学意义（RR=1.27，95%CI=1.00-1.62，p=0.05）。关于活产和持续妊娠率的亚组分析后，仅在胚胎移植前 5-12 分钟内给药的组报告有统计学意义的改善。
结论
在 IVF-胞浆内精子注射（ICSI）周期中，宫内输注 hCG 仅在胚胎移植前 5-12 分钟内给药才能改善结局。
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