激光辅助孵化对胚胎移植妊娠结局影响的Meta分析

Impact of laser-assisted hatching on pregnancy outcome: a Meta-analysis

目的:探究激光辅助孵化(LAH)对行胚胎移植不孕患者妊娠结局的影响。方法:计算机检索Pub Med、Ovid SP、Medline、Cochrane Library、CNKI、CBM、万方和维普等数据库,纳入LAH与其他多种辅助孵化方法和不作任何处理组比较的随机对照试验(RCT),检索年限截至2015年10月,语言不限,按照Cochrane协作组建议对纳入文献行质量评价和异质性分析,数据分析采用Rev Man 5.3.5软件。结果:纳入25个RCT;激光组分别与酸化组、机械组和对照组(不作任何处理)进行比较,继续妊娠率、流产率、活产率等差异均无统计学意义(P>0.05);对选择行冻融胚胎移植(FET)的患者,激光组较对照组有较高的种植率及临床妊娠率,差异有统计学意义(P<0.000 01;P<0.05);但多胎率显著增加(P<0.05)。结论:对选择行FET的患者,LAH较不做任何处理更有优势,可以提高种植率和临床妊娠率,值得推广及应用,但LAH会增加多胎发生的风险。

Objective： To evaluate the impact of laser-assisted hatching （LAH） on pregnancy outcome of infertile patients. Methods： Well-known databases at home and abroad were searched, then randomized controlled trials （RCTs） concerning the impact of LAH and non-LAH on pregnancy outcome were analyzed. Quality and heterogeneity of the articles were screened, and then relative risk （RR） was served as effective size to merge the studies. Results： Twenty-five relevant RCTs studies were included. There were no significant differences in the ongoing pregnancy rate, the miscarriage rate and the live birth rate （P〉0.05）. But for the frozen-thawed embryo of patients, LAH group could significantly improve the implantation rate and the clinical pregnancy rate （P〈0.000 01; P〈0.05） compared with control group. In addition, LAH can increase the incidence of multiple pregnancies （P〈0.05）. Conclusion： For the frozen-thawed embryo of patients, LAH was worthy to be popularized and applied and LAH can increase the incidence of multiple pregnancies.