接受体外受精的女性宫腔镜检查时进行子宫内膜搔刮术：一项系统评价与荟萃分析
Endometrial scratching during hysteroscopy in women undergoing fertilization: a systematic review and meta-analysis.
作者信息
Papanikolaou Evangelos, Peitsidis Nikolaos, Tsakiridis Ioannis, Michos Georgios, Skalias Antonios, Patoulias Dimitrios, Poutoglidis Alexandros, Mamopoulos Apostolos, Athanasiadis Apostolos, Grimpizis Grigorios, Najdecki Robert
机构信息
Assisting Nature IVF Centre and Genetics, Thessaloniki, Greece.
3rd Department of Obstetrics and Gynaecology, General Hospital Hippocrateion, Aristotle University of Thessaloniki, Thessaloniki, Greece.
出版信息
Front Surg. 2023 Sep 19;10:1225111. doi: 10.3389/fsurg.2023.1225111. eCollection 2023.
OBJECTIVE
Endometrial scratching (ES) during hysteroscopy before embryotransfer (ET) remains doubtable on whether it benefits the reproductive outcomes. The optimal technique is not clear and repeated implantation failure as a challenging field in fertilization (IVF) seems to be the springboard for clinicians to test its effectiveness.
METHODS
Medline, PMC, ScienceDirect, Scopus, CENTRAL, Google Scholar were searched from their inception up to April 2023 for studies to evaluate the effectiveness of adding endometrial scratching during hysteroscopy before ET.
RESULTS
The initial search yielded 959 references, while 12 eligible studies were included in the analyses, involving 2,213 patients. We found that hysteroscopy and concurrent ES before ET resulted in a statistically significant improvement in clinical pregnancy rate (CPR) [RR = 1.50, (95% CI 1.30-1.74), 0.0001] and live birth rate (LBR) [RR = 1.67, (95% CI 1.30-2.15), < 0.0001] with no statistically significant difference on miscarriage rate [RR = 0.80 (95% CI 0.52-1.22), = 0.30].
CONCLUSION
Our meta-analysis suggests that hysteroscopy with concurrent ES may be offered in IVF before ET as a potentially improving manipulation. Future randomized trials comparing different patient groups would also provide more precise data on that issue, to clarify specific criteria in the selection of patients.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42023414117).
目的
胚胎移植（ET）前宫腔镜检查时进行子宫内膜搔刮（ES）对生殖结局是否有益仍存在疑问。最佳技术尚不清楚，而反复种植失败作为体外受精（IVF）领域的一个具有挑战性的问题，似乎是临床医生测试其有效性的跳板。
方法
检索Medline、PMC、ScienceDirect、Scopus、CENTRAL、谷歌学术，从其创建至2023年4月，以查找评估ET前宫腔镜检查时增加子宫内膜搔刮有效性的研究。
结果
初步检索得到959篇参考文献，分析纳入12项符合条件的研究，涉及2213例患者。我们发现，ET前宫腔镜检查并同时进行ES可使临床妊娠率（CPR）[RR = 1.50，（95%CI 1.30 - 1.74），P = 0.0001]和活产率（LBR）[RR = 1.67，（95%CI 1.30 - 2.15），P < 0.0001]有统计学显著提高，而流产率无统计学显著差异[RR = 0.80（95%CI 0.52 - 1.22），P = 0.30]。
结论
我们的荟萃分析表明，ET前IVF中可进行宫腔镜检查并同时进行ES，作为一种可能改善结局的操作。未来比较不同患者组的随机试验也将提供关于该问题更精确的数据，以明确患者选择的具体标准。
系统评价注册
PROSPERO（CRD42023414117）
Zotero 插件