Department of Obstetrics and Gynecology, Centre for Reproductive Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Gynecol Obstet Invest. 2023;88(3):135-142. doi: 10.1159/000529400. Epub 2023 Feb 3.
Dienogest (DNG) was demonstrated to be comparable to gonadotropin-releasing hormone agonist (GnRH-a) in controlling symptoms of endometriosis. GnRH-a is used before in vitro fertilization (IVF) in women with endometriosis to improve pregnancy outcomes. We aimed to determine the effect of DNG pretreatment on IVF outcomes, including number of mature oocytes, rate of clinical pregnancies, and rate of live births in women with endometriosis.
All studies involving DNG, IVF, and endometriosis were searched from the PubMed; Ovid/MEDLINE, Wanfang, CQVIP, China National Knowledge Infrastructure databases; and ClinicalTrials.gov. The study population was women with endometriosis in IVF. Randomized controlled trials and cohort studies were included. All included studies comprised a DNG group and a control group. The outcomes were number of mature oocytes, rate of clinical pregnancies, and rate of live births. We calculated the odds ratio or mean difference and 95% confidence interval for each study and used a random-effects model to estimate the results.
Five articles were screened by the search strategy. One article without a control group was excluded. Finally, four articles with 422 patients were included. No significant differences in number of mature oocytes (MD = -1.27, 95% CI: -3.63 to 1.09, I2 = 91%), the rate of clinical pregnancies (odds ratio = 1.07, 95% CI: 0.33-3.47, I2 = 84%), or the rate of live births (odds ratio = 1.09, 95% CI: 0.34-3.46, I2 = 84%) were found between the DNG group and the control group.
Pretreatment with DNG for women with endometriosis who underwent IVF could not improve the number of mature oocytes, the rate of clinical pregnancies, or the rate of live births.
地诺孕素（DNG）已被证明在控制子宫内膜异位症症状方面与促性腺激素释放激素激动剂（GnRH-a）相当。 GnRH-a 常用于子宫内膜异位症患者的体外受精（IVF）前，以改善妊娠结局。我们旨在确定 DNG 预处理对 IVF 结局的影响，包括成熟卵母细胞数量、临床妊娠率和活产率。
从 PubMed、Ovid/MEDLINE、万方、维普、中国知网和 ClinicalTrials.gov 数据库中搜索所有涉及 DNG、IVF 和子宫内膜异位症的研究。研究人群为 IVF 中患有子宫内膜异位症的女性。纳入随机对照试验和队列研究。所有纳入的研究均包括 DNG 组和对照组。结局为成熟卵母细胞数量、临床妊娠率和活产率。我们计算了每项研究的优势比或均数差及其 95%置信区间，并使用随机效应模型估计结果。
通过搜索策略筛选出 5 篇文章。一篇没有对照组的文章被排除在外。最终，纳入了 4 篇包含 422 名患者的文章。两组在成熟卵母细胞数量（MD=-1.27，95%CI：-3.63 至 1.09，I2=91%）、临床妊娠率（优势比=1.07，95%CI：0.33-3.47，I2=84%）或活产率（优势比=1.09，95%CI：0.34-3.46，I2=84%）方面无显著差异。
对于接受 IVF 的子宫内膜异位症女性，DNG 预处理不能提高成熟卵母细胞数量、临床妊娠率或活产率。
