摘要
目的用Meta分析方法探讨激光辅助孵化对冻融胚胎移植结局的影响。方法计算机检索PubMed、Ebase、Cochrane Database、Google Scholar、中国生物医学文献服务系统(CBM)、中华医学期刊全文数据库、万方数据库,收集国内外有关冻融胚胎移植周期行激光辅助孵化的随机对照试验(RCTs)。对纳入的研究进行质量评价,采用RevMan5.3软件对种植率、临床妊娠率、流产率以及活产率进行meta分析。结果排除不符合纳入标准、失访人数不明确、重复发表、文献质量过低的研究后,共纳入6项RCTs,累计调查对象3685例,其中实验组(激光辅助孵化组)1802例,对照组1883例。Meta分析显示:与对照组相比,激光辅助孵化可提高种植率(OR=1.50,95%CI:1.01-2.22,P=0.04)和临床妊娠率(OR=1.41,95%CI:1.11-1.77,P=0.004),而对流产率(OR=1.10,95%CI:0.60-2.02,P=0.75)及活产率(OR=1.23,95%CI:0.91-1.68,P=0.18)没有影响。结论对冻融胚胎移植前进行激光辅助孵化可以一定程度地提高种植率及临床妊娠率,但对流产率和活产率没有显著影响,但更确切的结果仍需纳入更多的大样本优质研究以进一步验证。
Objective:Using Meta analysis method to explore the effect of laser-assisted hatching incubation on the outcome of freeze-thaw embryo transfer.Methods:Prospective,randomised,controlled studies of application of laser-assisted incubation on freeze-thaw embryo transfer were searched and screened in PubMed,Ebase,Cochrane Database,Google Scholar,China Biomedical Literature Service System(CBM),Chinese Medical Journal Full Text Database,and Database of Wanfang.After quality assessment and data extraction,a meta analysis was conducted in implantation rates,clinical pregnancy rates,miscarriage rates and live birth rates by Revman5.3 software.Results:After exclusion and selection,six studies with a total of 3685 cases(1802 with laser-assisted hatching and 1883 with contrast)were included in the analysis.Evidence of a beneficial effect of laser-assisted hatching was found for higher in implantation rate(OR=1.50,95%CI:1.01-2.22,P=0.04)and clinical pregnancy rate(OR=1.41,95%CI:1.11-1.77,P=0.004).There were no evidence that the application of laser-assisted incubation on freeze-thaw embryo transfer resulted in higher numbers of adverse events such as miscarriage rate(OR=1.10,95%CI:0.60-2.02,P=0.75)or live birth rate(OR=1.23,95%CI:0.91-1.68,P=0.18).Conclusions:The results of this meta-analysis suggest that the application of laser-assisted incubation on freeze-thaw embryo transfer could improve the implantation rate and clinical pregnancy rate without increasing the risk of adverse events.More large-scale high-quality studies still need to be included for further verification.
作者
丁洁
狄春光
王慧
王功发
王毅
王丽萍
DING Jie;DI Chun-guang;WANG Hui;WANG Gong-fa;WANG Yi;WANG Li-ping(Reproductive Center of Jiaxing Maternal and Child Health Care Hospital,Jiaxing 314000,Zhejiang)
出处
《中国优生与遗传杂志》
2020年第7期899-902,共4页
Chinese Journal of Birth Health & Heredity
关键词
冻融胚胎
激光辅助孵化
胚胎移植
META分析
Freeze-thaw embryo
Laser-assisted hatching
Embryo transfer
Meta-analysis
