■在接受辅助生殖技术(ART)的女性中,在卵母细胞刺激期间进行糖皮质激素治疗以治疗不孕症的兴趣一直存在。
■本荟萃分析旨在评估糖皮质激素辅助治疗对接受ART周期的不孕妇女妊娠结局的有效性和安全性。
■在PubMed中进行了文献检索,EMBASE,WebofScience,和Cochrane图书馆至2022年12月。为了评估接受IVF或ICSI治疗的女性在排卵诱导期间额外糖皮质激素治疗的有效性和安全性,仅纳入随机对照试验.
■总的来说,排卵期间的糖皮质激素治疗显示泼尼松龙改善活产率的效果不显著(OR=1.03,95%CI[.75,1.43],I2=.0%,p=.84),流产率(OR=1.14,95%CI[.62,2.08],I2=31%,p=.68),和植入率(OR=1.1,95%CI[.82,1.5],I2=8%,与对照组相比,不孕妇女的p=.52)。目前的荟萃分析显示,糖皮质激素治疗后每个周期的临床妊娠率趋于增加(OR=1.29,95%CI[1.02,1.63],I2=8%,p=.52)。
■本荟萃分析提示,在接受IVF/ICSI的妇女中,卵巢刺激泼尼松龙治疗不能显著改善临床结局。尽管结果表明,在促排卵期间进行糖皮质激素辅助治疗可能会增加临床妊娠率,亚组分析显示受不孕因素的影响,剂量时间表,和治疗的长度。因此,这些结果应谨慎解释.
UNASSIGNED: There is ongoing interest in glucocorticoid treatment during oocyte stimulation to treat infertility in women who have undergone Assisted Reproductive Technology (ART).
UNASSIGNED: This meta-analysis was performed to evaluate the efficiency and safety of adjuvant glucocorticoid therapy on pregnancy outcomes in infertile women undergoing ART cycles.
UNASSIGNED: A literature search was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library up to December 2022. To assess the efficacy and safety of additional glucocorticoid treatment during ovulation induction in women who underwent IVF or ICSI treatment, only randomized controlled trials were included.
UNASSIGNED: Overall, glucocorticoid therapy during ovulation showed a nonsignificant effect of prednisolone improving the live birth rate (OR = 1.03, 95% CI [.75, 1.43], I2 = .0%, p = .84), abortion rate (OR = 1.14, 95% CI [.62, 2.08], I2 = 31%, p = .68), and implantation rate (OR = 1.1, 95% CI [.82, 1.5], I2 = 8%, p = .52) of infertile women compared to the control group. The present meta-analysis revealed that the clinical pregnancy rate per cycle tended to increase after glucocorticoid treatment (OR = 1.29, 95% CI [1.02, 1.63], I2 = 8%, p = .52).
UNASSIGNED: The present meta-analysis suggested that ovarian stimulation prednisolone therapy does not significantly improve clinical outcomes in women undergoing IVF/ICSI. Although the results indicated that adjuvant glucocorticoid therapy during ovarian stimulation may increase the clinical pregnancy rate, subgroup analysis showed that it was affected by infertility factors, dose schedules, and length of treatment. Therefore, these results should be interpreted with caution.