目的:多项研究评估了雌激素受体(ER)多态性与控制性排卵过度刺激(COH)结局之间的关系。然而,结果仍然模糊。这项研究的目的是进行荟萃分析,以研究ER多态性与COH结局之间的联系。方法:从以下电子数据库中确定合格的研究:PubMed,Embase和中国CNKI至11月2021年。二分数据的比值比(OR)和95%置信区间(CI)以及连续变量的加权平均差(WMD)和95%置信区间(CI)用于计算ER多态性与COH结果之间的相关性。根据纳入和排除标准,共有13篇论文最终纳入了当前的荟萃分析.结果:本荟萃分析的主要发现如下:(1)PvuII基因多态性与所有模型的IVF妊娠结局有显著关系,除了隐性模型(CCVSTT:OR,5.51,95%CI,1.13,26.84;CC+CTVSTT:或,3.73,95%CI,1.21,11.57;CTVSTT:或,3.19,95%CI,1.11.9.16;CVST:OR,2.19,95%CI,1.15,4.19),具有较大或极端异质性;(2)XbaI多态性与杂合子和显性模型的IVF风险显着相关(AGVSGG:OR,0.27,95%CI,0.12,0.61;AAAGVSGG:或,0.27,95%CI,0.12,0.59),无异质性;(3)(TA)n多态性与纯合和隐性模型的IVF风险相关(LLVSSS:OR=3.74,95CI=1.53,9.12;LLVSLSSS:OR=2.75,95CI=1.18,6.38),无异质性;(4)Alul多态性及其与POR风险的关联,在隐性模型中观察到显著的关系(AAVSAG+GG:OR=2.27,95CI=1.46,3.54),无异质性;(5)PvuIIT/C突变不能预测卵泡数,卵母细胞数,卵泡与卵母细胞的比值与IVF的风险;(6)XbaI多态性与IVF的妊娠结局,在所有模型下均未观察到显著关联;(7)RsaI多态性在所有模型下均未增加POR风险.结论:总之,我们的荟萃分析发现有证据支持PvuII多态性可以作为预测IVF-ET妊娠率的标志物,XbaI和(TA)n多态性可能与不孕症有关,Alul多态性可预测卵巢对COH的低反应。有必要进行更精心设计的调查以证实这些发现。
Objective: Several studies evaluated the relationship between estrogen receptor (ER) polymorphisms and the outcomes of controlled ovulation hyperstimulation (
COH). However, the results remained obscure. The objective of this study was to perform a meta-analysis to investigate the links between ER polymorphisms and
COH outcomes.Methods: Eligible studies were identified from the following electronic databases: PubMed, Embase and the Chinese CNKI till Nov. 2021. The odds ratio (OR) and 95% confidence intervals (CIs) for dichotomous data and the weighted mean difference (WMD) with 95% confidence intervals (CIs) for continuous variables were used to calculate correlations between ER polymorphisms and
COH outcomes. Based on the inclusion and exclusion criteria, a total of thirteen papers were eventually enrolled in the current meta-analysis.Results: The following were the key findings of this meta-analysis: (1) PvuII polymorphism had a significant relationship with IVF pregnancy outcome in all models, except the recessive model(CC VS TT: OR, 5.51, 95% CI, 1.13,26.84; CC + CT VS TT: OR, 3.73, 95% CI, 1.21,11.57; CT VS TT: OR, 3.19, 95% CI, 1.11,9.16;C VS T: OR, 2.19, 95% CI, 1.15, 4.19), with large or extreme heterogeneity; (2) XbaI polymorphism had a significant association with IVF risk in heterozygous and dominant models(AG VS GG: OR, 0.27, 95% CI, 0.12,0.61; AAAG VS GG: OR, 0.27, 95% CI, 0.12,0.59), with no heterogeneity; (3) (TA)n polymorphism was linked with IVF risk in the homozygous and recessive models(LL VS SS:OR = 3.74, 95%CI = 1.53,9.12;LL VS LS + SS:OR = 2.75, 95%CI = 1.18, 6.38), with no heterogeneity; (4) for Alul polymorphism and its association with POR risk, significant relationship was observed in the recessive model(AA VS AG + GG:OR = 2.27, 95%CI = 1.46, 3.54), with no heterogeneity;(5) PvuII T/C mutation did not predict the follicle number, oocyte number, ratio of follicles to oocytes and the risk of IVF;(6) for XbaI polymorphism and pregnancy outcome of IVF, no significant association was observed under all models; and (7) RsaI polymorphism does not increase the risk of POR under all models.Conclusion: In summary, our meta-analysis found evidence supporting that PvuII polymorphism may serve as a marker in predicting pregnancy rate in IVF-ET, XbaI and (TA)n polymorphisms may be related with infertility, and Alul polymorphism may predict the poor ovarian response to
COH. More well-designed investigations are warranted to corroborate these findings.