Zhu Shaomi, Lv Zhexi, Song Linjiang, Zhang Qinxiu, Fan Yiyue, Li Junjun
School of Medical and Life Sciences/Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, Sichuan Province, China.
School of Medical and Life Sciences/Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Avenue, Wenjiang District, Chengdu, 611137, Sichuan Province, China.
Open Med (Wars). 2022 Nov 21;17(1):1811-1820. doi: 10.1515/med-2022-0594. eCollection 2022.
We conducted a systematic review and meta-analysis of all published data to determine the impact of estradiol pretreatment on reproductive outcomes and ovary stimulation characteristics for fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment with gonadotropin-releasing hormone (GnRH) antagonist protocol. MEDLINE, EMBASE, Cochrane Library, Web of Science, and China National Knowledge Infrastructure were searched, and any randomized controlled trials associated with estradiol pretreatment in GnRH antagonist protocol were included. Seven studies (1,236 patients) were included in the present study. The pooled data from the meta-analysis demonstrated no significant difference in ongoing pregnancy rate (odds ratio (OR): 0.92 (95% CI: 0.69-1.21; = 0.53) and live birth rate OR: 0.98 (95% CI: 0.74-1.30; = 0.90) between patients with and those without estradiol pretreatment in GnRH antagonist protocol. Duration of gonadotropin exposure, gonadotropin consumption, and the number of cumulus-oocyte complexes were not significantly different between groups. Luteal estradiol pretreatment in IVF/ICSI cycles with GnRH antagonist protocol in normal ovary responding population does not affect the reproductive outcomes. It is an encouraging option to facilitate cycle scheduling in GnRH antagonist protocol, for luteal estradiol pretreatment does not increase the duration of gonadotropin exposure or gonadotropin consumption.
我们对所有已发表的数据进行了系统评价和荟萃分析，以确定在使用促性腺激素释放激素（GnRH）拮抗剂方案进行体外受精（IVF）/卵胞浆内单精子注射（ICSI）治疗时，雌二醇预处理对生殖结局和卵巢刺激特征的影响。检索了MEDLINE、EMBASE、Cochrane图书馆、科学网和中国知网，并纳入了任何与GnRH拮抗剂方案中雌二醇预处理相关的随机对照试验。本研究纳入了7项研究（1236例患者）。荟萃分析的汇总数据显示，在GnRH拮抗剂方案中，接受雌二醇预处理和未接受雌二醇预处理的患者之间，持续妊娠率（优势比（OR）：0.92（95%置信区间：0.69-1.21；P=0.53））和活产率（OR：0.98（95%置信区间：0.74-1.30；P=0.90））无显著差异。两组之间促性腺激素暴露时间、促性腺激素用量和卵丘-卵母细胞复合体数量无显著差异。在正常卵巢反应人群中，采用GnRH拮抗剂方案的IVF/ICSI周期中进行黄体期雌二醇预处理不会影响生殖结局。黄体期雌二醇预处理不会增加促性腺激素暴露时间或促性腺激素用量，是促进GnRH拮抗剂方案中周期安排的一个令人鼓舞的选择。
