子宫内膜刺激术和行人工授精助孕患者妊娠结局关系的荟萃分析

Systematic evaluation of the influence of endometrial stimulation on pregnancy outcome in the patients with artificial insemination

目的 通过荟萃分析来验证子宫内膜刺激术和行人工授精术助孕患者妊娠结局之间的关系。方法 应用计算机检索了2000年1月至2016年5月与子宫内膜刺激术和行人工授精术助孕患者妊娠结局之间关系方面的中文和英文文献，检索包括在线数据库MEDLINE、CNKI、VIP、万方、EMBASE和Cochrane Library进行检索。分析包括6项研究，所有这些研究均是病例对照设计。6项研究共包括1 349例行人工授精助孕患者，其中行内膜微刺激术有734例。结果 行内膜刺激术的患者较未行任何处理的患者更易获得临床妊娠。试验组较对照组相比较，具有更高临床妊娠率（RR＝0.88, 95% CI： 0.82～0.95, P＝0.001），而流产率（RR＝0.72, 95% CI： 0.37～1.4, P＝0.33）和多胎率（RR＝0.78, 95% CI： 0.3～2.01, P＝0.60）两组差异无统计学意义。结论 子宫内膜刺激术有助于提高行人工授精术助孕患者的妊娠率，且不增加其流产率和多胎妊娠率。

Objective The association between endometrial stimulation and the intrauterine insemination outcome remains to be a controversial issue, for there being all kinds of conflicting data in the existing literatures. We conducted a Meta-analysis case to verify the relations between endometrial stimulation and intrauterine insemination （IUI）.Methods The articles had been searched in the following online databases： MEDLINE, CNKI, VIP, Wan Fang, EMBASE and the Cochrane Library. All of the statistics quoted for our studies have been published in English or Chinese from Jan, 2000 to May, 2016. Among the 6 studies included in this Meta-analysis, all of them used a case - control design. All the 6 studies evaluated a total of 1349 participants, including 734 cases of endometrial injury.Results The results of the Meta-analysis showed that patients with endometrial stimulation were more likely to receive clinical pregnancy than those who did not. Compared with the control group, the clinical pregnancy rate of experiment group was higher （RR=0.88, 95% CI： 0.82-0.95, P=0.001）, while the differences between their abortion rate （RR=0.72, 95% CI： 0.37-1.4, P=0.33） and multiple pregnancies rate （RR=0.78, 95% CI： 0.3-2.01, P=0.60） were insignificant.Conclusions Endometrial stimulation could help increase the pregnancy rate in IUI cycles, while the abortion rate and multiple pregnancies rate would not be raised.