目的:研究在一系列确定的主要终点方面,以个性化算法为基础的方式使用促卵泡素δ的卵巢刺激是否不如重组人卵泡刺激的促卵泡素α或促卵泡素β的常规给药。
方法:我们对PubMed-MEDLINE,WebofScience™,Cochrane系统评价数据库,还有Scopus.我们的搜索旨在涵盖所有相关文献,特别是随机对照试验。我们根据干预措施对每个主要终点的结果进行了批判性和比较性分析,βhCG试验阳性反映,临床妊娠,重要的怀孕,正在怀孕,活产,4周时活产,和多胎妊娠。
结果:六项随机对照试验被纳入质量评估,作为优先手稿,揭示了83.3%的低偏见风险。Follitropindelta导致每个感兴趣的参数与βhCG阳性检验无显著差异(691;53.44%vs.602;46.55%),持续怀孕(603;53.79%vs.518;46.20%),临床和重要妊娠(1,073;52.80%vs.959;47.19%),活产和4周时(595;54.14%vs.504;45.85%),只有2次亏损,甚至多胎妊娠(8;66.66%vs.4;33.33%)。然而,与follitropinalfa或follitropinbeta相比,follitropindelta在低反应和高反应者中耐受性良好,无明显的卵巢过度刺激综合征和/或预防性干预的风险.
结论:使用follitropindelta的个性化基于个性化的算法给药不劣于常规follitropinalfa或follitropinbeta。它在促进妇女的类似反应方面同样有效,而没有明显的可比不良反应。
OBJECTIVE: To investigate whether the ovarian stimulation with follitropin delta in an individualized algorithm-based manner is inferior to recombinant human-follicle stimulating\'s follitropin alfa or follitropin beta conventional dosing regarding a series of established primary endpoints.
METHODS: We conducted a registered systematic review (CRD42024512792) on PubMed-MEDLINE, Web of Science™, Cochrane Database of Systematic Reviews, and Scopus. Our search was designed to cover all relevant literature, particularly randomized controlled trials. We critically and comparatively analyzed the outcomes for each primary endpoint based on the intervention, reflected by the positive βhCG test, clinical pregnancy, vital pregnancy, ongoing pregnancy, live birth, live birth at 4 weeks, and multiple pregnancies.
RESULTS: Six randomized controlled trials were included in the quality assessment as priority manuscripts, revealing an 83.3% low risk of bias. Follitropin delta led to non-significant differences in each parameter of interest from positive βhCG test (691; 53.44% vs. 602; 46.55%), ongoing pregnancies (603; 53.79% vs. 518; 46.20%), clinical and vital pregnancies (1,073; 52.80% vs. 959; 47.19%), to live birth and at 4 weeks (595; 54.14% vs. 504; 45.85%) with only 2 losses, and even multiple pregnancies (8; 66.66% vs. 4; 33.33%). However, follitropin delta was well-tolerated among hypo- and hyper-responders without significant risk of ovarian hyperstimulation syndrome and/or preventive interventions in contrast with follitropin alfa or follitropin beta.
CONCLUSIONS: The personalized individualized-based algorithm dosing with follitropin delta is non-inferior to conventional follitropin alfa or follitropin beta. It is as effective in promoting a similar response in women without significant comparable adverse effects.