背景:卵巢低反应(POR)患者在辅助生殖技术中经常遇到周期取消和取卵障碍。富血小板血浆(PRP)卵巢注射是一种潜在的治疗方法,但是治疗方法不同,治疗结果存在争议。
目的:本研究在临床研究的基础上,采用系统评价和荟萃分析方法,探讨PRP注射液治疗POR的有效性和安全性。
方法:搜索以下数据库以查找2023年3月之前发表的研究;Medline(通过PubMed),WebofScience,Scopus,科克伦图书馆,Embase,科克伦图书馆,和中国国家知识基础设施数据库(CNKI)。然后由两名独立的研究人员对文献进行筛选,谁提取数据并评估其质量。根据纳入标准选择研究,并根据NOS标准队列研究评价其质量。纳入研究的偏倚风险采用STATE14.0进行评估。采用RevMan5.3软件进行Meta分析。
结果:分析中包括10项研究,包括7项前瞻性队列研究和3项涉及836例患者的回顾性研究.结果表明,PRP治疗后,POR患者卵泡刺激素(FSH)显著降低,抗穆勒激素(AMH)和黄体生成素(LH)显著升高,但雌二醇没有明显变化;窦卵泡数量增加,获得卵和成熟卵母细胞的数量显著增加;中期II型卵母细胞的数量,2PN和高质量的胚胎,卵裂期胚胎明显增加。此外,患者周期取消率显着下降。自然妊娠辅助生殖妊娠和活产率显著提高。4份报告明确表示没有观察到不良反应。
结论:PRP可能有可能改善POR患者的辅助生殖前指标,提高POR患者体外受精-胚胎移植(IVF-ET)的成功率,提高胚胎质量,并可能对妊娠结局有益。这项研究没有明显的潜在风险,但仍需要进一步的临床支持.
BACKGROUND: Poor ovarian response (POR) patients often encounter cycle cancellation and egg retrieval obstacles in assisted reproductive technology. Platelet rich plasma (PRP) ovarian injection is a potential treatment method, but the treatment methods are different, and the treatment results are controversial.
OBJECTIVE: This study adopts a systematic
review and meta-analysis method based on clinical research to explore the efficacy and safety of PRP injection on POR.
METHODS: The following databases were searched for research published before March 2023; Medline (via PubMed), Web of Science, Scopus, Cochrane Library, Embase, Cochrane Library, and China National Knowledge Infrastructure Database (CNKI). The literature was then screened by two independent researchers, who extracted the data and evaluated its quality. Research was selected according to the inclusion criteria, and its quality was evaluated according to the NOS standard Cohort study. The bias risk of the included study was assessed with STATE 14.0. RevMan 5.3 software was used for meta-analysis.
RESULTS: Ten studies were included in the analysis, including 7 prospective cohort studies and 3 retrospective studies involving 836 patients. The results showed that after PRP treatment, follicle stimulating hormone (FSH) significantly decreased and anti-Mueller hormone (AMH) and luteinizing hormone (LH) significantly increased in POR patients, but estradiol did not change significantly; The number of antral follicles increased, and the number of obtaining eggs and mature oocytes significantly increased; The number of Metaphase type II oocytes, 2PN and high-quality embryos, and cleavage stage embryos significantly increased. In addition, the patient cycle cancellation rates significantly decreased. The rate of natural pregnancy assisted reproductive pregnancy and live birth increased significantly. Four reports made it clear that no adverse reactions were observed.
CONCLUSIONS: PRP may have the potential to improve pre-assisted reproductive indicators in POR patients, increase the success rate of in vitro fertilization-embryo transfer (IVF-ET) in POR patients, and improve embryo quality, and may be beneficial to the pregnancy outcome. There is no obvious potential risk in this study, but further clinical support is still needed.