Department of Obstetrics and Gynecology, Faculty of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran.
Avicenna Infertility Clinic, Avicenna Research Institute, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.
J Med Life. 2023 Feb;16(2):189-194. doi: 10.25122/jml-2022-0095.
A promising strategy for controlling repeated implantation failure (RIF) may be the use of hydroxychloroquine (HCQ). To the best of our knowledge, no systematic review has been conducted on the effects of hydroxychloroquine on pregnancy outcomes. A systematic research of the following electronic databases was conducted: Cochrane, EMBASE-Ovid, PubMed, Web of Science, and Scopus from inception to December 2021, using the following keywords [hydroxychloroquine] AND [infertility]. Fertilization and rate of live birth were significantly higher in the HCQ+ prednisone (PDN) group than in the PDN alone group. However, the abortion rate was not different between the two groups. The meta-analysis of two studies revealed no statistical significance between the PDN group and HCQ+PDN group regarding clinical pregnancy rate (OR=.14 [95%CI: 0.4-4.370]; heterogeneity; P=0.13; I2=54%; random effect model) and implantation rate (OR=1.99 [95%CI: 0.94-4.2]; heterogeneity; P=0.37; I2=0%; fixed-effect model). While HCQ may help improve fertilization and live birth rates, adding it to prednisone did not improve overall pregnancy outcomes. This systematic review should be used with caution due to the small size, study design, and difference in the studies' population.
一种有前途的控制反复着床失败（RIF）的策略可能是使用羟氯喹（HCQ）。据我们所知，目前还没有对羟氯喹对妊娠结局的影响进行系统评价。我们对以下电子数据库进行了系统研究：Cochrane、EMBASE-Ovid、PubMed、Web of Science 和 Scopus，从开始到 2021 年 12 月，使用以下关键字 [羟氯喹] AND [不孕]。HCQ+泼尼松（PDN）组的受精率和活产率明显高于 PDN 组。然而，两组的流产率没有差异。两项研究的荟萃分析显示，PDN 组和 HCQ+PDN 组之间的临床妊娠率（OR=.14 [95%CI：0.4-4.370]；异质性；P=0.13；I2=54%；随机效应模型）和着床率（OR=1.99 [95%CI：0.94-4.2]；异质性；P=0.37；I2=0%；固定效应模型）无统计学意义。虽然 HCQ 可能有助于提高受精率和活产率，但添加泼尼松并不能改善整体妊娠结局。由于研究规模较小、研究设计以及研究人群的差异，本系统评价应谨慎使用。
