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阿托西班可改善胚胎移植结局。一项随机和非随机试验的系统评价和荟萃分析。

Atosiban improves the outcome of embryo transfer. A systematic review and meta-analysis of randomized and non-randomized trials.

机构信息

Reproductive Medicine at Clinica Las Condes, Santiago, Chile.

Obstetrics and Gynecology Department, Universidad de Santiago, Chile.

出版信息

JBRA Assist Reprod. 2020 Oct 6;24(4):421-427. doi: 10.5935/1518-0557.20200016.

Abstract

OBJECTIVE

To estimate the effectiveness of Atosiban in improving the outcome after embryo transfer. The effectiveness of embryo transfer per cycle is still relatively low. One possible explanation might be uterine contractility that expels the transferred embryos. Atosiban improved the outcome of embryo transfer by reducing uterine contractility.

METHODS

Data sources: A systematic review of papers in English using MEDLINE and EMBASE (1990-2019). Search terms included Atosiban, embryo transfer. Study selection: We included studies that compared the outcomes of embryo transfer with Atosiban and a control group. Data Extracting: Independent extraction of papers by two authors, using predefined data fields, including study quality indicators.

RESULTS

All pooled analyses were based on a fixed-effect model. Four randomised controlled trials, including 1,025 women, and two non-randomised trials, including 686 patients, met our inclusion criteria. In both studies, the heterogeneity was moderate. Atosiban increased clinical pregnancy rates regardless of the indication for ART or type of embryo transferred. Pooled OR in randomized controlled trials reached 1.47 (1.18-1.82), and in non-randomised controlled trials it reached 1.50 (95% CI 1.10-2.05).

CONCLUSION

Atosiban appears to increase the clinical pregnancy rates in women undergoing embryo transfer.

摘要

目的

评估阿托西班在改善胚胎移植后结局方面的有效性。每个周期的胚胎移植成功率仍然相对较低。一种可能的解释是子宫收缩将移植的胚胎排出。阿托西班通过降低子宫收缩来提高胚胎移植的成功率。

方法

资料来源:使用 MEDLINE 和 EMBASE(1990-2019 年)对英文文献进行系统评价。搜索词包括阿托西班、胚胎移植。研究选择:我们纳入了比较阿托西班与对照组治疗后胚胎移植结局的研究。资料提取:两位作者独立提取论文,使用预设的数据字段,包括研究质量指标。

结果

所有汇总分析均基于固定效应模型。四项随机对照试验,包括 1025 名女性,和两项非随机试验,包括 686 名患者,符合我们的纳入标准。在这两项研究中,异质性为中度。阿托西班增加了临床妊娠率,无论 ART 的适应证或移植胚胎的类型如何。随机对照试验的汇总 OR 达到 1.47(1.18-1.82),非随机对照试验的 OR 达到 1.50(95%CI 1.10-2.05)。

结论

阿托西班似乎可以提高接受胚胎移植的女性的临床妊娠率。

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