■根据现有的随机对照试验(RCT),定量评估辅酶Q10(CoQ10)预处理对卵巢储备功能减退(DOR)女性IVF或ICSI结局的影响。
■从数据库开始到2023年11月1日,对9个数据库进行了全面搜索,以确定合格的RCT。感兴趣的生殖结局包括三个主要结局和六个次要结局。采用敏感性分析验证了合并结果的稳健性。
■总共有六个RCT,共有1529名接受IVF/ICSI不孕症治疗的DOR参与者。现有证据的回顾表明,辅酶Q10预处理与临床妊娠率升高显著相关(OR=1.84,95CI[1.33,2.53],p=0.0002),最佳胚胎数量(OR=0.59,95CI[0.21,0.96],p=0.002),检索到的卵母细胞数(MD=1.30,95CI[1.21,1.40],p<0.00001),HCG当天的E2水平(SMD=0.37,95CI[0.07,0.66],p=0.01),随着周期取消率的降低(OR=0.60,95CI[0.44,0.83],p=0.002),流产率(OR=0.38,95CI[0.15,0.98],p=0.05),Gn应用的总天数(MD=-0.89,95CI[-1.37,-0.41],p=0.0003),和使用的Gn总剂量(MD=-330.44,95CI[-373.93,-286.96],p<0.00001)。敏感性分析表明,我们的合并结果是稳健的。
■这些研究结果表明,辅酶Q10预处理是改善DOR妇女IVF/ICSI结局的有效干预措施。尽管如此,这项荟萃分析纳入的样本量相对有限,但方法学描述较差.今后需要进行严格的试验。
UNASSIGNED: To quantitatively evaluate the effect of coenzyme Q10 (CoQ10) pretreatment on outcomes of IVF or ICSI in women with diminished ovarian reserve (DOR) based on the existing randomized controlled trials (RCTs).
UNASSIGNED: Nine databases were comprehensively searched from database inception to November 01, 2023, to identify eligible RCTs. Reproductive outcomes of interest consisted of three primary outcomes and six secondary outcomes. The sensitivity analysis was adopted to verify the robustness of pooled results.
UNASSIGNED: There were six RCTs in total, which collectively involved 1529 participants with DOR receiving infertility treatment with IVF/ICSI. The review of available evidence suggested that CoQ10 pretreatment was significantly correlated with elevated clinical pregnancy rate (OR = 1.84, 95%CI [1.33, 2.53], p = 0.0002), number of optimal embryos (OR = 0.59, 95%CI [0.21, 0.96], p = 0.002), number of oocytes retrieved (MD = 1.30, 95%CI [1.21, 1.40], p < 0.00001), and E2 levels on the day of hCG (SMD = 0.37, 95%CI [0.07, 0.66], p = 0.01), along with a reduction in cycle cancellation rate (OR = 0.60, 95%CI [0.44, 0.83], p = 0.002), miscarriage rate (OR = 0.38, 95%CI [0.15, 0.98], p = 0.05), total days of Gn applied (MD = -0.89, 95%CI [-1.37, -0.41], p = 0.0003), and total dose of Gn used (MD = -330.44, 95%CI [-373.93, -286.96], p < 0.00001). The sensitivity analysis indicated that our pooled results were robust.
UNASSIGNED: These findings suggested that CoQ10 pretreatment is an effective intervention in improving IVF/ICSI outcomes for women with DOR. Still, this meta-analysis included relatively limited sample sizes with poor descriptions of their methodologies. Rigorously conducted trials are needed in the future.