Gan Joscelyn, Rozen Genia, Polyakov Alex
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
Reproductive Services, Royal Women's Hospital, Parkville, Victoria, Australia.
BMJ Open. 2022 Apr 26;12(4):e051489. doi: 10.1136/bmjopen-2021-051489.
This study aims to review the literature and perform a meta-analysis to determine if the presence of a corpus luteum has an impact on treatment outcomes in thaw cycles, where blastocyst embryos are transferred.
PUBMED, EMBASE, CENTRAL and CINAHL were searched for papers published between January 2017 and 27 July 2020. Additional articles were selected from the reference list of the results and previous reviews. Three reviewers independently reviewed and extracted data. The meta-analysis was conducted though RevMan V.5.4.1. Studies were quality assessed with the Cochrane risk of bias tool and the Newcastle-Ottawa Scale.
Nine publications were included for data extraction and subsequent meta-analysis. Two studies were randomised controlled trials, and seven were cohort studies. Subgroup analysis of the different study designs was performed. While the rates of positive human chorionic gonadotropin results (relative risk, RR 1.0, 95% CI 0.95 to 1.05) and clinical pregnancies (RR 1.06, 95% CI 0.96 to 1.18) were comparable between the two groups, the rates of live births were higher in thaw cycles with a corpus luteum (RR 1.14, 95% CI 1.06 to 1.22). Analysis of pregnancy losses demonstrated that both biochemical pregnancy (early miscarriage) (RR 0.71, 95% CI 0.62 to 0.82) and miscarriages (RR 0.72, 95% CI 0.62 to 0.83) were increased in cycles without a corpus luteum.
Where clinically appropriate, the use of cycle types that have a functional corpus luteum should be favoured. There were several limitations to this study, including the quality of studies and the inherent bias of retrospective cohort studies. Further, high-quality research, particularly randomised controlled trials with blastocysts embryos, is required to further explore these findings.
CRD42020209583.
本研究旨在回顾文献并进行荟萃分析，以确定黄体的存在是否会对囊胚胚胎移植的解冻周期治疗结果产生影响。
检索了PUBMED、EMBASE、CENTRAL和CINAHL中2017年1月至2020年7月27日发表的论文。从结果的参考文献列表和先前的综述中选择了其他文章。三名评审员独立进行评审并提取数据。通过RevMan V.5.4.1进行荟萃分析。使用Cochrane偏倚风险工具和纽卡斯尔-渥太华量表对研究进行质量评估。
纳入9篇出版物进行数据提取和后续荟萃分析。两项研究为随机对照试验，七项为队列研究。对不同研究设计进行了亚组分析。虽然两组之间人绒毛膜促性腺激素阳性结果率（相对风险，RR 1.0，95%CI 0.95至1.05）和临床妊娠率（RR 1.06，95%CI 0.96至1.18）相当，但有黄体的解冻周期活产率更高（RR 1.14，95%CI 1.06至1.22）。妊娠丢失分析表明，无黄体的周期中生化妊娠（早期流产）（RR 0.71，95%CI 0.62至0.82）和流产（RR 0.72，95%CI 0.62至0.83）均增加。
在临床合适的情况下，应优先使用具有功能性黄体的周期类型。本研究存在若干局限性，包括研究质量和回顾性队列研究的固有偏倚。此外，需要高质量的研究，特别是关于囊胚胚胎的随机对照试验，以进一步探索这些发现。
PROSPERO注册号：CRD42020209583。
