ADAMTS 蛋白聚糖酶下调与多囊卵巢综合征患者 IVF-ET 结局的相关性：系统评价和荟萃分析。

Association of ADAMTS proteoglycanases downregulation with IVF-ET outcomes in patients with polycystic ovary syndrome: a systematic review and meta-analysis.

机构信息

School of Public Health, China Medical University, Shenyang, China.

Reproductive and Genetic Medicine Center, Dalian Women and Children's Medical Center, Dalian, China.

出版信息

Reprod Biol Endocrinol. 2022 Dec 13;20(1):169. doi: 10.1186/s12958-022-01035-9.

DOI:10.1186/s12958-022-01035-9

PMID:36510316

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9745937/

Abstract

BACKGROUND

A disintegrin and metalloproteinase with thrombospondin-like motifs (ADAMTS) is involved in inflammation and fertility in women with polycystic ovary syndrome (PCOS). This study aims to assess the role of ADAMTS level in the outcomes of in vitro fertilization and embryo transfer (IVF-ET) in women with PCOS, using a meta-analytic approach.

METHODS

We systematically searched Web of Science, PubMed, EmBase, and the Cochrane library to identify potentially eligible studies from inception until December 2021. Study assess the role of ADAMTS levels in patients with PCOS was eligible in this study. The pooled effect estimates for the association between ADAMTS level and IVF-ET outcomes were calculated using the random-effects model.

RESULTS

Five studies involving a total of 181 patients, were selected for final analysis. We noted that ADAMTS-1 levels were positively correlated to oocyte maturity (r = 0.67; P = 0.004), oocyte recovery (r = 0.74; P = 0.006), and fertilization (r = 0.46; P = 0.041) rates. Moreover, ADAMTS-4 levels were positively correlated to oocyte recovery (r = 0.91; P = 0.001), and fertilization (r = 0.85; P = 0.017) rates. Furthermore, downregulation of ADAMTS-1, ADAMTS-4, ADAMTS-5, and ADAMTS-9 was associated with elevated follicle puncture (ADAMTS-1: weighted mean difference [WMD], 7.24, P < 0.001; ADAMTS-4: WMD, 7.20, P < 0.001; ADAMTS-5: WMD, 7.20, P < 0.001; ADAMTS-9: WMD, 6.38, P < 0.001), oocytes retrieval (ADAMTS-1: WMD, 1.61, P < 0.001; ADAMTS-4: WMD, 3.63, P = 0.004; ADAMTS-5: WMD, 3.63, P = 0.004; ADAMTS-9: WMD, 3.20, P = 0.006), and Germinal vesicle oocytes levels (ADAMTS-1: WMD, 2.89, P < 0.001; ADAMTS-4: WMD, 2.19, P < 0.001; ADAMTS-5: WMD, 2.19, P < 0.001; ADAMTS-9: WMD, 2.89, P < 0.001). Finally, the oocytes recovery rate, oocyte maturity rate, fertilization rate, cleavage rate, good-quality embryos rate, blastocyst formation rate, and clinical pregnancy rate were not affected by the downregulation of ADAMTS-1, ADAMTS-4, ADAMTS-5, and ADAMTS-9 (P > 0.05).

CONCLUSIONS

This study found that the outcomes of IVF-EF in patients with PCOS could be affected by ADAMTS-1 and ADAMTS-4; further large-scale prospective studies should be performed to verify these results.

摘要

背景

解整合素和金属蛋白酶与凝血酶反应基序（ADAMTS）参与多囊卵巢综合征（PCOS）女性的炎症和生育能力。本研究旨在通过荟萃分析评估 ADAMTS 水平在 PCOS 患者体外受精和胚胎移植（IVF-ET）结局中的作用。

方法

我们系统地检索了 Web of Science、PubMed、EmBase 和 Cochrane 图书馆，以确定从成立到 2021 年 12 月期间可能符合条件的研究。本研究纳入了评估 ADAMTS 水平在 PCOS 患者中作用的研究。使用随机效应模型计算 ADAMTS 水平与 IVF-ET 结局之间关联的汇总效应估计值。

结果

最终纳入了 5 项共 181 例患者的研究进行分析。我们发现 ADAMTS-1 水平与卵母细胞成熟度（r=0.67；P=0.004）、卵母细胞回收（r=0.74；P=0.006）和受精率（r=0.46；P=0.041）呈正相关。此外，ADAMTS-4 水平与卵母细胞回收（r=0.91；P=0.001）和受精率（r=0.85；P=0.017）呈正相关。此外，ADAMTS-1、ADAMTS-4、ADAMTS-5 和 ADAMTS-9 的下调与卵泡穿刺（ADAMTS-1：加权均数差 [WMD]，7.24，P<0.001；ADAMTS-4：WMD，7.20，P<0.001；ADAMTS-5：WMD，7.20，P<0.001；ADAMTS-9：WMD，6.38，P<0.001）、卵母细胞回收（ADAMTS-1：WMD，1.61，P<0.001；ADAMTS-4：WMD，3.63，P=0.004；ADAMTS-5：WMD，3.63，P=0.004；ADAMTS-9：WMD，3.20，P=0.006）和卵母细胞的生发泡（ADAMTS-1：WMD，2.89，P<0.001；ADAMTS-4：WMD，2.19，P<0.001；ADAMTS-5：WMD，2.19，P<0.001；ADAMTS-9：WMD，2.89，P<0.001）呈正相关。最后，ADAMTS-1、ADAMTS-4、ADAMTS-5 和 ADAMTS-9 的下调对卵母细胞回收率、卵母细胞成熟率、受精率、卵裂率、优质胚胎率、囊胚形成率和临床妊娠率没有影响（P>0.05）。