背景:FIGO(国际妇产科联合会)3型肌瘤对体外受精(IVF)的影响尚不确定。
目的:评估FIGO3型肌瘤是否影响IVF结局,通过系统评价和荟萃分析(CRD42022379700)。
方法:搜索电子数据库直到2022年11月15日。
方法:研究评估FIGO3型肌瘤对IVF结局的影响。
方法:汇总结果以比值比(OR)和95%置信区间(CI)表示。使用HigginsI2评估异质性。通过敏感性和亚组分析探索异质性的来源。
结果:总计,包括1020例患者:324例FIGO3型肌瘤和696例对照(无肌瘤)。汇总数据分析显示活产率显着降低(OR2.16,95%CI1.55-3.01,I2=0%,P<0.00001),临床妊娠率(OR2.06,95%CI1.52-2.81,I2=0%,P<0.00001),和植入率(OR1.77,95%CI1.35-2.32,I2=0%,与对照组相比,未经治疗的肌瘤女性的P<0.00001)。肌瘤的数量和大小与IVF结局恶化相关。
结论:FIGO3型肌瘤与较低的植入率显著相关,累积妊娠率,和活产率。此外,它们对IVF结局的有害影响随着大小和数量的增加而进一步增加。然而,关于FIGO3型子宫肌瘤手术对IVF结局的潜在益处,目前尚无确切结论.
BACKGROUND: The effect of FIGO (the International Federation of Gynecology & Obstetrics) type 3 myomas on in vitro fertilization (IVF) is uncertain.
OBJECTIVE: To evaluate whether FIGO type 3 myomas affect IVF outcomes, through a systematic
review and meta-analysis (CRD42022379700).
METHODS: Electronic databases were searched until November 15, 2022.
METHODS: Studies evaluating the effects of FIGO type 3 myomas on IVF outcome.
METHODS: Pooled results were expressed as odds ratios (OR) with 95% confidence intervals (CI). Heterogeneity was assessed using Higgins I2 . Sources of heterogeneity were explored with sensitivity and subgroup analyses.
RESULTS: In total, 1020 patients were included: 324 with FIGO type 3 myomas and 696 controls (without myomas). A pooled data analysis showed a significantly lower live birth rate (OR 2.16, 95% CI 1.55-3.01, I2 = 0%, P < 0.00001), clinical pregnancy rate (OR 2.06, 95% CI 1.52-2.81, I2 = 0%, P < 0.00001), and implantation rate (OR 1.77, 95% CI 1.35-2.32, I2 = 0%, P < 0.00001) in women with untreated myomas compared with controls. The number and size of fibroids correlated with a worsening of IVF outcomes.
CONCLUSIONS: FIGO type 3 myomas are significantly associated with a lower implantation rate, cumulative pregnancy rate, and live birth rate. Furthermore, their deleterious effect on the outcome of IVF increases further with increasing size and number. Nevertheless, no firm conclusions could be drawn about the potential benefits of surgery for FIGO type 3 uterine fibroids on IVF outcomes.