目的:探讨延长hCG-卵子拾取间隔是否能改善辅助生殖技术结局。
方法:中央,CNKI,Cochrane系统评论,EMBASE,MEDLINE,pubmed,和截至2023年5月13日的WebofScience被搜索报告hCG-卵子拾取间隔和辅助生殖技术结果之间关联的研究。干预类型包括辅助生殖技术周期中的短(≤36h)和长(>36h)hCG卵拾取间隔。所有结果仅基于新鲜胚胎移植。主要结局定义为临床妊娠率。使用随机效应模型汇集数据。异质性使用I2统计数据进行评估。
结果:12项研究纳入荟萃分析,包括五项回顾性队列研究,一项前瞻性队列研究,和6项随机或准随机对照试验。短间隔组和长间隔组的卵母细胞成熟率相似,受精率和优质胚胎率(OR,0.69;95%CI,0.45-1.06;I2=91.1%,OR,0.88;95%CI,0.77-1.0;I2=44.4%,OR,1.05;95%CI,0.95-1.17;I2=8.6%,分别)。长取出组的临床妊娠率明显高于短取出组(OR,0.66;95%CI,0.45-0.95;I2=35.4%)。两组的流产率和活产率相似(OR,1.92;95%CI,0.66-5.60;I2=0.0%,OR,0.50;95%CI,0.24-1.04;I2=0.0%,分别)。
结论:临床妊娠率可以通过延长人绒毛膜促性腺激素获取间隔来提高。这将有助于我们为生育中心和患者制定更合理的时间表。
■PROSPEROCRD42022310006(2022年4月28日)。
OBJECTIVE: To explore whether prolonged hCG-ovum pickup interval improves assisted reproductive technology outcomes.
METHODS: CENTRAL, CNKI, Cochrane Systematic Reviews, EMBASE, MEDLINE, PUBMED, and Web of Science up to May 13 2023 were searched for studies reporting associations between hCG-ovum pickup intervals and assisted reproductive technology outcomes. Intervention types included short (≤ 36 h) and long (> 36 h) hCG-ovum pickup intervals in assisted reproductive technology cycles. All outcomes were based upon only fresh embryo transfers. Primary outcome is defined as the clinical pregnancy rate. Data were pooled using random-effects models. Heterogeneity was assessed using the I 2 statistics.
RESULTS: Twelve studies were included in the meta-analysis, including five retrospective cohort studies, one prospective cohort study, and six randomized or quasi-randomized controlled trials. The short and long interval groups had similar oocyte maturation rates, fertilization rate and high-quality embryo rate (OR, 0.69; 95% CI, 0.45-1.06; I 2 = 91.1%, OR, 0.88; 95% CI, 0.77-1.0; I 2 = 44.4% and OR, 1.05; 95% CI, 0.95-1.17; I 2 = 8.6%, respectively). The clinical pregnancy rates in the long retrieval group were significantly higher than in the short retrieval group (OR, 0.66; 95% CI, 0.45-0.95; I 2 = 35.4%). The groups had similar miscarriage and live birth rates (OR, 1.92; 95% CI, 0.66-5.60; I 2 = 0.0% and OR, 0.50; 95% CI, 0.24-1.04; I 2 = 0.0%, respectively).
CONCLUSIONS: The clinical pregnancy rates can be increased by prolonging the hCG-ovum pickup interval, which would help us develop more reasonable time schedules for fertility centers and patients.
UNASSIGNED: PROSPERO CRD42022310006 (28 Apr 2022).