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宫腔镜检查能否改善不孕女性的生育结局：一项荟萃分析与系统评价

Whether hysteroscopy improves fertility outcomes in infertile women: a meta-analysis and systematic review.

作者信息

Wang Yidi, Tang Zunhao, Wang Chanchan, Teng Xiuxiang, He Junqin

机构信息

Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.

College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.

出版信息

Front Endocrinol (Lausanne). 2024 Dec 16;15:1489783. doi: 10.3389/fendo.2024.1489783. eCollection 2024.

DOI:10.3389/fendo.2024.1489783
PMID:39736864
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11683682/
Abstract

PURPOSE

Infertility is affecting more and more couples of appropriate age. Hysteroscopy (HSC) has certain effects on the uncompleted pregnancy and live birth caused by uterine microenvironment. Based on the evidence, this paper systematically evaluates the effectiveness and safety of HSC intervention on the fertility outcome of female infertility.

METHODS

Randomised controlled trials (RCTS) of hysteroscopy intervention in female infertility were included in the literature database. The retrieval time was from the establishment of the database to December 10, 2022. RevMan 5.4 software was used for statistical analysis to study the effects of HSC on clinical pregnancy rate, live birth rate and abortion rate.

RESULTS

A total of 14 RCTS were included. Five studies evaluated the effect of HSC on live birth rate, and HSC had an overall positive effect on live birth rate. Fourteen studies evaluated the effect of HSC on clinical pregnancy rates, and preoperative HSC was associated with significant improvements in pregnancy rates for both first-time IVF/ICSI patients and repeat IVF/ICSI patients. Eight studies showed no significant difference in the effect of HSC on miscarriage rates.

CONCLUSION

As a visual examination/treatment technique, HSC can improve the clinical pregnancy rate and live birth rate in most studies, while the risk of abortion is within the acceptable range, and can be used as a recommended examination method for infertile women.

摘要

目的

不孕症正影响着越来越多的适龄夫妇。宫腔镜检查（HSC）对由子宫微环境导致的妊娠未完成和活产有一定影响。基于这些证据，本文系统评价了HSC干预对女性不孕症生育结局的有效性和安全性。

方法

将宫腔镜干预女性不孕症的随机对照试验（RCTs）纳入文献数据库。检索时间为从数据库建立至2022年12月10日。使用RevMan 5.4软件进行统计分析，以研究HSC对临床妊娠率、活产率和流产率的影响。

结果

共纳入14项RCTs。5项研究评估了HSC对活产率的影响，HSC对活产率总体有积极影响。14项研究评估了HSC对临床妊娠率的影响，术前HSC对首次体外受精/卵胞浆内单精子注射（IVF/ICSI）患者和重复IVF/ICSI患者的妊娠率均有显著改善。8项研究表明HSC对流产率的影响无显著差异。

结论

作为一种可视化检查/治疗技术，在大多数研究中HSC可提高临床妊娠率和活产率，同时流产风险在可接受范围内，可作为不孕症女性的推荐检查方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/0fdbe4bad3be/fendo-15-1489783-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/d1a630b19012/fendo-15-1489783-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/475f6af89c55/fendo-15-1489783-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/750da989d1ba/fendo-15-1489783-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/105ac7a0cd44/fendo-15-1489783-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/8408f7363e05/fendo-15-1489783-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/8e81145c7708/fendo-15-1489783-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/0fdbe4bad3be/fendo-15-1489783-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/d1a630b19012/fendo-15-1489783-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/475f6af89c55/fendo-15-1489783-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/750da989d1ba/fendo-15-1489783-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/105ac7a0cd44/fendo-15-1489783-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/8408f7363e05/fendo-15-1489783-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/8e81145c7708/fendo-15-1489783-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5c/11683682/0fdbe4bad3be/fendo-15-1489783-g007.jpg

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The effects of diagnostic hysteroscopy on the reproductive outcomes of infertile women without intrauterine pathologies: a systematic review and meta-analysis.诊断性宫腔镜检查对无子宫内病变的不孕妇女生殖结局的影响：一项系统评价和荟萃分析。
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Hysteroscopic Resection of Endometrial Polyps and Assisted Reproductive Technology Pregnancy Outcomes Compared with No Treatment: A Systematic Review.宫腔镜子宫内膜息肉切除术与未治疗的辅助生殖技术妊娠结局比较的系统评价。
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