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宫腔内输注自体富血小板血浆对接受辅助生殖技术治疗的女性的影响:一项随机对照试验的荟萃分析

Effects of Intrauterine Infusion of Autologous Platelet-Rich Plasma in Women Undergoing Treatment with Assisted Reproductive Technology: a Meta-Analysis of Randomized Controlled Trials.

作者信息

Hu Shifu, Jin Zhishan, Tang Qianqian

机构信息

Obstetrics and Gynecology Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Geburtshilfe Frauenheilkd. 2022 Dec 13;83(4):453-462. doi: 10.1055/a-1963-7459. eCollection 2023 Apr.

Abstract

This meta-analysis was conducted to systematically retrieve relevant randomized controlled trials (RCTs) and evaluate the effects of intrauterine infusion of autologous platelet-rich plasma (PRP) in women with thin endometrium, implantation or pregnancy failure undergoing treatment with assisted reproductive technology (ART). We conducted a systematic review and meta-analysis of the retrieved RCTs. Studies on the intrauterine infusion of PRP in women undergoing treatment with ART that were published in PubMed, the Cochrane library, Web of Science, and Embase from inception until June 2022 were included. The data were extracted and analyzed independently using the fixed-effects or random-effects model according to heterogeneity. Seven RCTs involving 861 patients (435 in the intervention group and 426 in the control group) were included. The rates of clinical pregnancy (risk ratio [RR]: 2.51; 95% confidence interval [CI]: 2.0-3.13; P < 0.00001), chemical pregnancy (RR: 1.96; 95% CI: 1.58-2.45; P < 0.00001), live births (RR: 7.03; 95% CI: 3.91-12.6; P < 0.00001), and implantation (RR: 3.27; 95% CI: 1.42-7.52; P = 0.005) were significantly higher in the women who received PRP infusion than in the control group. No significant differences were noted in the miscarriage rate (RR: 0.98; 95% CI: 0.39-2.42; P = 0.96) between the two groups. In summary, intrauterine infusion of PRP may be an effective therapy for women with thin endometrium and recurrent implantation failure (RIF) undergoing treatment with ART. More population-based RCTs are warranted to verify the efficacy of our evidence.

摘要

本荟萃分析旨在系统检索相关随机对照试验(RCT),并评估宫腔内输注自体富血小板血浆(PRP)对子宫内膜薄、接受辅助生殖技术(ART)治疗但着床或妊娠失败的女性的影响。我们对检索到的RCT进行了系统评价和荟萃分析。纳入了从创刊至2022年6月在PubMed、Cochrane图书馆、科学网和Embase上发表的关于ART治疗女性宫腔内输注PRP的研究。根据异质性,使用固定效应或随机效应模型对数据进行独立提取和分析。纳入了7项RCT,涉及861例患者(干预组435例,对照组426例)。接受PRP输注的女性临床妊娠率(风险比[RR]:2.51;95%置信区间[CI]:2.0 - 3.13;P < 0.00001)、生化妊娠率(RR:1.96;95% CI:1.58 - 2.45;P < 0.00001)、活产率(RR:7.03;95% CI:3.91 - 12.6;P < 0.00001)和着床率(RR:3.27;95% CI:1.42 - 7.52;P = 0.005)均显著高于对照组。两组间流产率无显著差异(RR:0.98;95% CI:0.39 - 2.42;P = 0.96)。总之,宫腔内输注PRP可能是ART治疗的子宫内膜薄和反复着床失败(RIF)女性的有效治疗方法。需要更多基于人群的RCT来验证我们证据的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33c1/10076096/9749bc1dbd0c/10-1055-a-1963-7459-i19652939.jpg

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