■没有明确的证据表明子宫内膜致密的临床意义,这可以通过胚胎移植前卵泡-黄体过渡期间子宫内膜厚度(EMT)的减少来衡量。在这项研究中,我们旨在确定子宫内膜致密化是否对体外受精(IVF)成功有影响.
■我们搜索了PubMed,科克伦,Embase,和WebofScience电子数据库,用于截至2023年3月以英文发表的研究。使用I2统计量评估研究之间的异质性。随机效应模型和固定效应模型用于汇集风险比(RR)和相应的95%置信区间(CI)。根据不同的超声测量方法和不同的子宫内膜紧实率(ECR)进行亚组分析。采用Stata17.0软件进行Meta分析。妊娠结局,其中包括临床妊娠率,持续怀孕率,活产率,和自然流产率,进行了评估。
■在这项研究中,包括18项队列研究,涉及16164个胚胎移植周期。汇总结果表明,子宫内膜致密化组和非致密化组的临床妊娠率没有显着差异(RR[95%CI]=0.98[0.90,1.08];I2=69.76%),持续妊娠率(RR[95%CI]=1.18[0.95,1.47];I2=78.77%),活产率(RR[95%CI]=0.97[0.92,1.02];I2=0.00%)或自然流产率(RR[95%CI]=1.07[0.97,1.26];I2=0.00%)。根据超声波测量方法的亚组分析,在经阴道超声(TVUS)联合腹部超声(AUS)的子宫内膜致密组,持续妊娠率(RR[95%CI]=1.69[1.26,2.26];I2=29.27%)和活产率(RR[95%CI]=1.27[1.00,1.61];I2=62.28%)显著高于非致密化组。此外,基于ECR的亚组分析显示,当ECR≥15%时,持续妊娠率明显更高(RR[95%CI]=1.99[1.61,2.47];I2=0.00%).
■子宫内膜致密化对临床妊娠率无不良影响,持续怀孕率,活产率,或自然流产率。对于先前研究的矛盾发现,可能的解释在于测量EMT的方法。
■https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42023430511,标识符CRD42023430511。
There is no clear evidence of clinical significance of endometrial compaction, which can be measured by a reduction in endometrial thickness (EMT) during the follicular-luteal transition before the day of embryo transfer. In this study, we aim to determine whether endometrial compaction has an effect on in vitro fertilization (IVF) success.
We searched PubMed, Cochrane, Embase, and Web of Science electronic databases for studies published in English up to March 2023. Heterogeneity between studies was assessed using the I2 statistic. The random effects model and fixed effects model was used to pool the risk ratio (RR) with a corresponding 95% confidence interval (CI). A subgroup analysis was performed based on different methods of ultrasonic measurement and different endometrial compaction rates (ECR). Stata 17.0 software was used for meta-analysis. Pregnancy outcomes, which included clinical pregnancy rate, ongoing pregnancy rate, live birth rate, and spontaneous abortion rate, were evaluated.
In this study, 18 cohort studies were included, involving 16,164 embryo transfer cycles. Pooled results indicated that there was no significant difference between the endometrial compaction group and the non-compaction group in terms of clinical pregnancy rate (RR [95% CI]=0.98 [0.90,1.08]; I2 = 69.76%), ongoing pregnancy rate (RR [95% CI]=1.18 [0.95,1.47]; I2 = 78.77%), live birth rate (RR [95% CI]= 0.97 [0.92,1.02]; I2 = 0.00%) or spontaneous abortion rate (RR [95% CI]= 1.07[0.97,1.26]; I2 = 0.00%). According to the subgroup analysis of ultrasonic measurement methods, in the transvaginal ultrasound (TVUS) combined with abdominal ultrasonography (AUS) cycles of the endometrial compaction group, the rate of ongoing pregnancy (RR [95% CI] = 1.69 [1.26, 2.26]; I2 = 29.27%) and live birth (RR [95% CI] = 1.27 [1.00,1.61]; I2 = 62.28%) was significantly higher than that of the non-compaction group. Additionally, subgroup analysis based on ECR revealed a significantly higher rate of ongoing pregnancy when ECR ≥ 15% (RR [95% CI] = 1.99 [1.61, 2.47]; I2 = 0.00%).
Endometrial compaction has no adverse effect on clinical pregnancy rate, ongoing pregnancy rate, live birth rate, or spontaneous abortion rate. A possible explanation for the contradictory findings of previous studies lies in the method by which the EMT is measured.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023430511, identifier CRD42023430511.