子宫内膜异位症对 IVF/ICSI 及围产结局的影响：系统评价和荟萃分析。

The effect of endometriosis on IVF/ICSI and perinatal outcome: A systematic review and meta-analysis.

机构信息

Center for Reproductive Medicine, Shandong University, Jinan, Shandong 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, Shandong, 250012, China.

出版信息

J Gynecol Obstet Hum Reprod. 2022 Nov;51(9):102446. doi: 10.1016/j.jogoh.2022.102446. Epub 2022 Jul 26.

DOI:10.1016/j.jogoh.2022.102446

PMID:35905901

Abstract

PURPOSE

The purpose of the study was whether endometriosis influences IVF/ICSI and subsequent pregnancy and obstetric outcomes.

METHODS

Searches were performed on PubMed, EMBASE, Medline, and Web of Science. Most of the included studies were retrospective case control study and retrospective cohort study. The risk ratio with 95% confidence intervals were calculated using the random and fixed effects model. Random effects models were applied in the case of significant heterogeneity (I>50%), and fixed effects models were used if the heterogeneity was not significant. The main outcome measure was the live birth rate.

RESULTS

Seventy studies were included in our analysis. Compared with the control group, the implantation rate (p = 0.04) and the number of oocyte retrieved (p<0.00001) were significantly lower in women with endometriosis. About late pregnancy complications, there were significant statistical differences in multiple pregnancies rate, placenta previa rate, ectopic pregnancy rate, and postpartum hemorrhage rate between the two groups (p<0.05). All other major reproductive and obstetric outcomes were similar in women with and without endometriosis.

CONCLUSIONS

Our results demonstrate women with or without endometriosis have similar reproductive outcomes, but women with endometriosis who conceived after assisted reproductive technology are in high risk pregnancy.

摘要

目的

本研究旨在探讨子宫内膜异位症是否会影响体外受精/卵胞浆内单精子注射（IVF/ICSI）及其后续妊娠和产科结局。

方法

检索 PubMed、EMBASE、Medline 和 Web of Science 数据库。大多数纳入的研究为回顾性病例对照研究和回顾性队列研究。使用随机效应模型和固定效应模型计算风险比及其 95%置信区间。如果存在显著异质性（I>50%），则应用随机效应模型；如果异质性不显著，则使用固定效应模型。主要结局指标为活产率。

结果

本研究共纳入 70 项研究。与对照组相比，子宫内膜异位症患者的胚胎着床率（p=0.04）和获卵数（p<0.00001）显著降低。关于晚期妊娠并发症，两组间多胎妊娠率、前置胎盘率、异位妊娠率和产后出血率存在显著统计学差异（p<0.05）。而其他主要生殖和产科结局在子宫内膜异位症患者和非子宫内膜异位症患者之间相似。