發(fā)布時(shí)間：2019-03-17 12:58

【摘要】：目的：系統(tǒng)評(píng)價(jià)輔助孵化(AH)對(duì)反復(fù)種植失敗(RIF)患者再次助孕治療的臨床妊娠結(jié)局的影響。方法：計(jì)算機(jī)檢索Cochrane圖書(shū)館、MEDLINE、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、相關(guān)期刊論文、中文科技期刊全文數(shù)據(jù)庫(kù)、萬(wàn)方數(shù)據(jù)庫(kù),檢索時(shí)限至2013年10月。納入在RIF患者應(yīng)用AH的隨機(jī)對(duì)照試驗(yàn),由兩名評(píng)價(jià)員獨(dú)立提取資料,并對(duì)其方法學(xué)質(zhì)量進(jìn)行評(píng)價(jià)。對(duì)符合納入標(biāo)準(zhǔn)的研究用RevMan5.0軟件進(jìn)行Meta分析。結(jié)果：共檢索到符合納入標(biāo)準(zhǔn)隨機(jī)對(duì)照的文獻(xiàn)7篇,共有研究對(duì)象1621例,其中AH組793例,對(duì)照組828例。Meta分析結(jié)果顯示：與對(duì)照組對(duì)比,AH組的臨床妊娠率顯著提高[OR=1.99,95%CI(1.22,3.23),P=-0.006],每胚胎的種植率亦顯著提高[OR=2.11,95%CI(1.17,3.80),P=0.01]；AH組與對(duì)照組的活產(chǎn)率比較,AH組的活產(chǎn)率更高且差異有統(tǒng)計(jì)學(xué)意義[OR=2.04,95%CI(1.07,3.89),P=0.03]；但對(duì)于多胎妊娠率的比較,對(duì)照組的多胎妊娠率相對(duì)較低且差異有統(tǒng)計(jì)學(xué)意義[OR=1.58,95%CI(1.05,2.37),P=0.03]；流產(chǎn)率比較兩組無(wú)統(tǒng)計(jì)學(xué)差異[OR=I.62,95%CI(0.75,3.50),P=0.22]。結(jié)論：AH可以改善RIF患者再次助孕治療的某些臨床結(jié)局,如提高妊娠率、每胚胎種植率和活產(chǎn)率。AH不會(huì)增加流產(chǎn)率,但有增加多胎妊娠率的風(fēng)險(xiǎn)。由于納入研究方法學(xué)質(zhì)量、樣本量所限,該結(jié)論尚需大樣本、高質(zhì)量的隨機(jī)對(duì)照試驗(yàn)進(jìn)一步證實(shí)。
[Abstract]:Objective: to evaluate the effect of assisted hatching (AH) on the pregnancy outcome of repeated implantation failed (RIF) patients. Methods: the Cochrane Library, MEDLINE, Chinese Biomedical Literature Database, Chinese Journal full-text Database, Chinese sci-tech Journal full-text Database and Wanfang Database were searched by computer. The time limit of retrieval was up to October 2013. A randomized controlled trial of AH was used in patients with RIF. The data were extracted independently by two evaluators and their methodological quality was evaluated. Meta analysis was carried out with RevMan5.0 software for the research which met the inclusion criteria. Results: a total of 7 randomized controlled articles were found. There were 1621 subjects, including 793 cases in AH group and 828 cases in control group. The results of meta-analysis showed that: compared with the control group, there were 793 cases in the study group and 828 cases in the control group. The clinical pregnancy rate in AH group was significantly increased [OR=1.99,95%CI (1.22,3.23), P < 0.006], and the implantation rate per embryo was also significantly increased [OR=2.11,95%CI (1.17,3.80), P0. 01]. The survival rate of AH group was higher than that of control group [OR=2.04,95%CI (1.07, 3.89), P < 0.05]. The survival rate of AH group was significantly higher than that of control group [OR=2.04,95%CI (1.07, 3.89), P < 0.05]. However, the multiple pregnancy rate of the control group was lower than that of the control group [OR=1.58,95%CI (1.05, 2.37), P = 0.03], but the multiple pregnancy rate of the control group was significantly lower than that of the control group (1.05, 2.37). There was no significant difference in abortion rate between the two groups [OR=I.62,95%CI (0.75, 3.50), P = 0.22]. Conclusion: AH can improve some clinical outcomes of RIF patients, such as increasing pregnancy rate, per embryo implantation rate and living rate. AH does not increase abortion rate, but has the risk of increasing multiple pregnancy rate. Due to the quality of the research methodology and the limited sample size, the conclusion needs to be further confirmed by a high-quality randomized controlled trial.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.8

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 樊文倩;孫瑩璞;蘇迎春;郭藝紅;;體外受精中各因素與單卵雙胎的相關(guān)性分析[J];國(guó)際生殖健康/計(jì)劃生育雜志;2013年04期

2 聶玲;伍瓊芳;曾韓;黃志輝;;激光輔助孵化在反復(fù)種植失敗及凍融胚胎移植患者中的應(yīng)用[J];江西醫(yī)藥;2012年01期

3 魏麗坤;張雷;王藹明;;子宮內(nèi)膜容受性的評(píng)價(jià)及其改善措施[J];生殖與避孕;2008年05期

4 馬龍;錢(qián)曉喬;蔡令波;馮婷;嚴(yán)正杰;印惠榮;劉嘉茵;;全胚冷凍再行解凍胚胎移植周期的臨床結(jié)局分析[J];生殖與避孕;2012年04期

5 敖磊;馬艷萍;相立峰;鄧蓮;高夢(mèng)瑩;鄧波;李明穎;李永剛;;兩種不同激光輔助孵化方法在卵裂期凍融胚胎移植中的比較研究[J];實(shí)用婦產(chǎn)科雜志;2013年02期

6 夏婷婷;李潔;徐慧靈;于文娟;王東;;體外受精-胚胎移植中反復(fù)種植失敗婦女血清催產(chǎn)素水平初步分析[J];中華臨床醫(yī)師雜志(電子版);2009年12期

7 孫偉;李靜;聞姬;;人胚胎透明帶與輔助孵化的研究進(jìn)展[J];中國(guó)優(yōu)生與遺傳雜志;2007年12期

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