子宫腺肌病和子宫内膜异位症女性冷冻全胚与新鲜胚胎移植周期的妊娠结局：一项系统评价和荟萃分析。
Pregnancy outcomes in freeze-all versus fresh embryo transfer cycles of women with adenomyosis and endometriosis: a systemic review and meta-analysis.
作者信息
Han Yixian, Liu Chang, Liu Dong, Wu Lukanxuan, Huang Wei
机构信息
Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China.
出版信息
Front Endocrinol (Lausanne). 2025 May 14;16:1507252. doi: 10.3389/fendo.2025.1507252. eCollection 2025.
BACKGROUND
Endometriosis (EMS) and adenomyosis have adverse effects on women's fertility. fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are effective treatments for these diseases. Research has shown that different embryo transfer strategies in IVF/ICSI can influence gestational outcomes. This systematic review and meta-analysis aimed to evaluate the impact of freeze-all embryo transfer (FET) versus fresh embryo transfer (ET) strategies in IVF/ICSI cycles for infertile women with EMS and adenomyosis.
METHOD
A comprehensive search was conducted across PubMed, EMBASE, MEDLINE, Web of Science, Google Scholar, and Chinese databases to identify studies examining different embryo transfer strategies in IVF/ICSI cycles among patients with EMS and adenomyosis. The outcomes analyzed included rates of implantation, clinical pregnancy, miscarriage, and live birth. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects or fixed-effects models.
RESULTS
In patients with EMS, the results demonstrated that the FET strategy yielded higher clinical pregnancy (OR: 1.25; 95% CI: 1.11, 1.40), live birth rates (OR: 1.31; 95% CI: 1.15, 1.49), and implantation rates (OR: 1.27; 95% CI: 1.05, 1.54) compared to the fresh ET strategy. The miscarriage rate (OR: 0.89; 95% CI: 0.52, 1.52) and the ectopic pregnancy rate (OR: 0.51; 95% CI: 0.24, 1.07) were comparable between groups. For the group of women with adenomyosis, the IVF/ICSI outcomes were comparable between the FET and fresh ET strategies.
CONCLUSION
In IVF/ICSI, the FET strategy has been associated with more favorable reproductive outcomes compared to the fresh ET strategy in women with EMS. Whereas in women with adenomyosis, pregnancy outcomes were comparable between the FET and fresh ET groups.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024563268, identifier CRD42024563268.
背景
子宫内膜异位症（EMS）和子宫腺肌病对女性生育能力有不良影响。体外受精（IVF）和卵胞浆内单精子注射（ICSI）是治疗这些疾病的有效方法。研究表明，IVF/ICSI中不同的胚胎移植策略会影响妊娠结局。本系统评价和荟萃分析旨在评估在IVF/ICSI周期中，冷冻全胚移植（FET）与新鲜胚胎移植（ET）策略对患有EMS和子宫腺肌病的不孕女性的影响。
方法
全面检索了PubMed、EMBASE、MEDLINE、Web of Science、谷歌学术和中文数据库，以确定研究EMS和子宫腺肌病患者在IVF/ICSI周期中不同胚胎移植策略的研究。分析的结局包括着床率、临床妊娠率、流产率和活产率。使用随机效应或固定效应模型计算95%置信区间（CI）的比值比（OR）。
结果
在EMS患者中，结果表明，与新鲜ET策略相比，FET策略的临床妊娠率（OR：1.25；95%CI：1.11，1.40）、活产率（OR：1.31；95%CI：1.15，1.49）和着床率（OR：1.27；95%CI：1.05，1.54）更高。两组间流产率（OR：0.89；95%CI：0.52，1.52）和异位妊娠率（OR：0.51；95%CI：0.24，1.07）相当。对于子宫腺肌病女性组，FET和新鲜ET策略的IVF/ICSI结局相当。
结论
在IVF/ICSI中，与新鲜ET策略相比，FET策略与患有EMS的女性更有利的生殖结局相关。而对于患有子宫腺肌病的女性，FET组和新鲜ET组的妊娠结局相当。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024563268，标识符CRD42024563268。
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