Reproductive Health Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Breastfeeding Research Center, Family Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
BMC Pregnancy Childbirth. 2024 Sep 18;24(1):605. doi: 10.1186/s12884-024-06801-8.
An enduring challenge for women diagnosed with Turner syndrome (TS) is infertility. Oocyte donation (OD) offers a chance of pregnancy for these patients. However, current data on pregnancy outcomes are inadequate. Hence, this systematic review aims to explore the clinical outcomes of OD in patients with TS.
A systematic search was conducted in PubMed, Web of Sciences, Scopus, and Embase for relevant papers from 1 January 1990 to 30 November 2023. Our primary research objective is to determine the live birth rate among women with TS who have undergone in vitro fertilization (IVF) using OD for fertility purposes. Specifically, we aim to calculate the pooled live birth rates per patient and per embryo transfer (ET) cycle. For secondary outcomes, we have analyzed the rates of clinical pregnancy achievement per ET cycle and the incidence of gestational hypertensive complications per clinical pregnancy. Prevalence meta-analyses were performed using STATA 18.0 by utilizing a random-effects model and calculating the pooled rates of each outcome using a 95% confidence interval (CI).
A total of 14 studies encompassing 417 patients were systematically reviewed. Except for one prospective clinical trial and one prospective cohort study, all other 12 studies had a retrospective cohort design. Our meta-analysis has yielded a pooled live birth rate per patient of 40% (95% CI: 29-51%; 14 studies included) and a pooled live birth rate per ET cycle of 17% (95% CI: 13-20%; 13 studies included). Also, the pooled clinical pregnancy achievement rate per ET cycle was estimated at 31% (95% CI: 25-36%; 12 studies included). Moreover, the pooled rate of pregnancy-induced hypertensive disorders per clinical pregnancy was estimated at 12% (95% CI: 1-31%; 8 studies included). No publication bias was found across all analyses.
This study demonstrated promising pregnancy outcomes for OD in patients with TS. Further studies are essential to address not only the preferred techniques, but also the psychological, ethical, and societal implications of these complex procedures for these vulnerable populations.
This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration code CRD42023494273.
特纳综合征（TS）患者面临的一个持久挑战是不孕。卵子捐赠（OD）为这些患者提供了怀孕的机会。然而，目前关于妊娠结局的数据不足。因此，本系统综述旨在探讨 OD 在 TS 患者中的临床妊娠结局。
系统检索了 1990 年 1 月 1 日至 2023 年 11 月 30 日期间 PubMed、Web of Sciences、Scopus 和 Embase 中的相关文献。我们的主要研究目标是确定接受 OD 进行生育目的的 TS 女性进行体外受精（IVF）后的活产率。具体来说，我们旨在计算每位患者和每个胚胎移植（ET）周期的活产率。对于次要结局，我们分析了每个 ET 周期的临床妊娠率和每个临床妊娠的妊娠高血压并发症发生率。使用 STATA 18.0 进行了患病率荟萃分析，采用随机效应模型，使用 95%置信区间（CI）计算每个结局的汇总率。
系统综述共纳入 14 项研究，涵盖 417 例患者。除了一项前瞻性临床试验和一项前瞻性队列研究外，其他 12 项研究均为回顾性队列设计。我们的荟萃分析得出，每位患者的活产率为 40%（95%CI：29-51%；纳入 14 项研究），每个 ET 周期的活产率为 17%（95%CI：13-20%；纳入 13 项研究）。此外，每个 ET 周期的临床妊娠率估计为 31%（95%CI：25-36%；纳入 12 项研究）。此外，每个临床妊娠的妊娠高血压疾病发生率估计为 12%（95%CI：1-31%；纳入 8 项研究）。所有分析均未发现发表偏倚。
本研究表明，OD 在 TS 患者中具有良好的妊娠结局。需要进一步研究不仅要确定首选技术，还要研究这些复杂程序对这些弱势群体的心理、伦理和社会影响。
本系统综述在国际前瞻性系统评价注册库（PROSPERO）中注册，注册号为 CRD42023494273。
