子宫内膜微创术对首次行IVF/ICSI患者妊娠结局影响的Meta分析

Meta-analysis of effect of endometrial scratch injury on first cycle IVF/ICSI outcome

目的探讨子宫内膜微创术对首次行IVF/ICSI不孕女性妊娠结局的影响。方法从PubMed、EMbase、MEDLINE、Cochrane Library、CNKI、CBM、万方和维普数据库,筛选有关子宫内膜微创术与首次行IVF/ICSI患者妊娠结局的随机对照研究,检索时限自建库至2019年2月,根据纳入标准和排除标准对文献进行筛选、质量评估和资料提取,采用RevMan 5.3软件进行Meta分析。结果本研究最终纳入4篇随机对照研究,Meta分析结果表明:子宫内膜微创术组的种植率[RR=1.29,95%CI(1.08,1.53),P=0.005]和临床妊娠率[RR=1.43,95%CI(1.03,1.98),P=0.03]显著高于对照组;两组患者流产率[RR=0.66,95%CI(0.29,1.47),P=0.31]、活产率[RR=1.36,95%CI(0.71,2.60),P=0.35]和多胎妊娠率[RR=1.20,95%CI(0.89,1.62),P=0.23]比较差异无统计学意义。结论子宫内膜微创术能改善首次行IVF/ICSI患者的种植率和临床妊娠率,但不增加流产率、活产率和多胎妊娠率。

Objective:To investigate the effect of endometrial scratch injury on pregnancy outcome in patients with the first cycle IVF/ICSI.Methods:Data are obtained from Pubmed,EMbase,MEDLINE,Cochrane Library,CNKI,CBM,Wanfang and Weipu database.All randomized controlled trials involving the effect of endometrial scratch injury on first cycle IVF/ICSI outcome were screened.The retrieval period was from the establishment of the database to February 2019.The literatures were screened according to the inclusion and exclusion criteria,followed by quality evaluation and data extraction.The RevMan 5.3 software was used for data analysis.Results:Four randomized controlled trials were included.The analysis results showed that the implantation rate[RR=1.29,95%CI(1.08,1.53),P=0.005]and clinical pregnancy rate[RR=1.43,95%CI(1.03,1.98),P=0.03]in endometrial scratch injury group were significantly higher than those in control group.There were no significant differences in abortion rate[RR=0.66,95%CI(0.29,1.47),P=0.31],live birth rate[RR=1.36,95%CI(0.71,2.60),P=0.35]and multiple pregnancy rate[RR=1.20,95%CI(0.89,1.62),P=0.23].Conclusions:Endometrial scratch injury can improve the implantation rate and clinical pregnancy rate on first cycle IVF/ICSI in patients,but it does not increase the abortion rate,live rate and multiple pregnancy rate.