Objective This study aimed to combine tumor abnormal protein(TAP) and high-sensitivity C-reactive protein(hs-CRP) level detection to diagnose endometrial cancer in patients with endometrial thickness less than 8 mm, a...Objective This study aimed to combine tumor abnormal protein(TAP) and high-sensitivity C-reactive protein(hs-CRP) level detection to diagnose endometrial cancer in patients with endometrial thickness less than 8 mm, and to provide a reference for clinical screening and diagnosis. Methods Clinical data from 19 cases of endometrial cancer, diagnosed on the basis of pathological findings, were collected from September 2014 to December 2015. The inclusion criteria were as follows: the patients were first diagnosed with endometrial thickness less than 8 mm and were all in menopause. Perimenopausal patients(n = 26) with uterine fibroids seen during the same period were selected as a control group. Serum TAP and hs-CRP levels of the patients in the two groups were simultaneously determined on admission. Results We found that both TAP and hs-CRP levels in the experimental group were higher than those in the control group [(182.95 ± 72.14) μm^2 vs.(133.19 ± 55.18) μm^2, P = 0.019;(7.52 ± 19.03) mg/L vs.(1.66 ± 2.31) mg/L, P = 0.136]. The sensitivity of TAP for the diagnosis of endometrial cancer was 73.68%, the specificity was 69.23%, and the Youden index was 0.4291. The diagnostic sensitivity and specificity of hs-CRP was 15.79% and 100%, respectively, and the Youden index was 0.1579. After plotting the receiver operating characteristics curves, the optimal cut-off value for TAP in diagnosing endometrial cancer was found to be 160.662 μm^2 and that for hs-CRP was 1.07 mg/L. Conclusion For patients suspected of having endometrial cancer with endometrial thickness less than 8 mm, combined detection of TAP and hs-CRP levels can be used as a screening tool and can provide new ideas regarding clinical diagnosis and treatment.展开更多
Background: Women with polycystic ovary syndrome (PCOS) are at higher risk of developing endometrial hyperplasia (EH). This study determined the prevalence of EH among women with infertility due to PCOS and assessed t...Background: Women with polycystic ovary syndrome (PCOS) are at higher risk of developing endometrial hyperplasia (EH). This study determined the prevalence of EH among women with infertility due to PCOS and assessed the predictive value of endometrial thickness (ET) measurement by trans-vaginal scan (TVS). Study Type & Population: This was a prospective study on infertile women with and without PCOS in which clinical data, hormonal profile, ET and endometrial biopsy (EB) for histopathological examination were collected. Methods: Thirty-seven women with PCOS and 23 women without PCOS presenting with infertility and/or abnormal uterine bleeding underwent TVS, hysteroscopy, laparoscopy and EB. Results: The overall prevalence of EH was 23.3 % while in PCOS group: 18.3 %. The mean ET (14.8 mm) was significantly higher in patients with EH (t = -2.74, P value = 0.009). The lower value of ET among women with EH was 10 mm. A cut-off point of 9.5 mm was set. An ET of >9.5 mm had 92.9% sensitivity and 51.85% specificity for the presence of EH. Women with ET ≥ 9.5 mm were 1.28 times more at risk of EH than women with ET 9.5 mm. Women with oligomenorrhea and irregular cycles were 5.5 and 13.7 times more at risk of EH compared to those with regular cycles, respectively. ET was positively correlated with insulin resistance (r = 0.439, P = 0.007). Conclusion: ET ≥ 9.5 mm predicts EH in infertile women with PCOS, with a high degree of sensitivity and a moderate degree of specificity. In PCOS patients with oligomenorrhea or irregular cycles, the risk of EH is higher than women with regular cycles.展开更多
Background: Polycystic ovarian syndrome (PCOS) is considered the commonest endocrinological disorder affecting reproductive aged women. PCOS compromises fertility through various pathways. These pathways include hyper...Background: Polycystic ovarian syndrome (PCOS) is considered the commonest endocrinological disorder affecting reproductive aged women. PCOS compromises fertility through various pathways. These pathways include hyperandrogenism, insulin resistance and impedance of the uterine and endometrial blood flow. Metformin improves the blood flow to the endometrium. It acts by reducing androgen level and correction of insulin resistance. Endometrial vascular indices were evaluated in this study to evaluate endometrial receptivity in anovulatory patients with PCOS. Aim of the Work: To evaluate the outcome of metformin administration in anovulatory patients with PCOS and its effect on the endometrium. This included its role in ovulation and improvement of pregnancy rates. Patients and Methods: This study included 85 patients from Ain Shams University outpatient infertility clinics from 1st of January, 2018 till 30th of June, 2018. We investigated these patients before treatment with ultrasound on day 14, 21. We evaluated endometrial thickness, uterine artery flow pattern, endometrial and subendometrial flow patterns. The patients received metformin 500 mg three times per day for three months. After this duration, we reevaluated them by ultrasound at days 14, 21. Results: Metformin therapy resulted in a significant increase of endometrial thickness and had a significant decrease on uterine, endometrial and subendometrial resistance index (R.I) and pulsatility index (P.I) at day 14, 21 compared to pre-treatment values indicating better blood flow. Conclusion: Metformin therapy resulted in improvement of endometrial flow patterns. Also, it resulted in increase in endometrial thickness and improvement of uterine artery flow.展开更多
Background: Transvaginal color Doppler sonography of the uterine artery has been reported useful for evaluation of abnormal uterine bleeding in peri-/post-menopausal women. It may differentiate physiological from mali...Background: Transvaginal color Doppler sonography of the uterine artery has been reported useful for evaluation of abnormal uterine bleeding in peri-/post-menopausal women. It may differentiate physiological from malignant endometrial changes. Objective: Evaluating the endometrial thickness and uterine artery Doppler as an initial diagnostic tool to identify patients with abnormal endometrial pathology. Methods: This is a prospective case control study consisted of total 50 women with peri-(n = 35) and post-(n = 15) menopausal bleeding, with 20 women consisting control group (no bleeding) (peri-(n = 10) and post-menopausal (n = 10)). Double layer endometrial thickness and uterine-artery-Doppler waveforms were measured, with the latter being S/D ratio, RI and PI. These were related to histological findings (endometrial biopsy). Result: Patients with abnormal uterine bleeding (both peri- and postmenopausal) had a significantly higher mean endometrial thickness than the control women. Study group showed a significantly lower value of all Doppler indices (S/D ratio, RI and PI). In study group, patients with malignant endometrial pathology showed significantly thicker endometrium and significantly lower Doppler indices than those with benign pathology. Conclusion: The combination of endometrial thickness and uterine artery color Doppler pattern might predict uterine endometrial malignancy, although whether it can discriminate (screen) patients requiring endometrial biopsy is not evident. Further study is needed.展开更多
Endometrial receptivity is an important factor that influences embryo implantation.Thus,it is important to identify an applicable approach to improve endometrial receptivity in women undergoing assisted reproductive t...Endometrial receptivity is an important factor that influences embryo implantation.Thus,it is important to identify an applicable approach to improve endometrial receptivity in women undergoing assisted reproductive technology.Recently,growing evidence has indicated that intrauterine platelet-rich plasma(PRP)infusion is an effective method to obtain a satisfactory reproductive outcome by increasing endometrial thickness and improving endometrial receptivity.Therefore,the present review aims to outline the possible mechanisms of PRP on endometrial receptivity and summarize the present literature on the effects of PRP therapy in improving endometrial receptivity.展开更多
Background: A thickened endometrium in the postmenopausal patient is a common reason for referral to gynaecology rapid access clinics under the cancer targets wait. This can often be an incidental finding in the asymp...Background: A thickened endometrium in the postmenopausal patient is a common reason for referral to gynaecology rapid access clinics under the cancer targets wait. This can often be an incidental finding in the asymptomatic patient. Investigation of this can be invasive, uncomfortable and carries significant surgical risk. Aims: This paper aims to summarise all the recent literature to see if there is any clear consensus on who should be further investigated in this select group of patients. Methods: Systematic literature review. Results: The studies varied greatly on the need for further investigation in asymptomatic women with endometrial thickness greater than 11 mm, with some deciding on careful case selection for further investigation, and others investigating every patient. The treatment of asymptomatic patients with endometrium classified as thickened, yet under 11 mm and no symptoms again varied in case selection and further investigation. Endometrial polyps were mentioned in 1 paper, suggesting that asymptomatic polyps need not be removed, which is contrary to current clinical practice. Conclusion: There is no overall opinion as to the exact treatment of women with thickened endometrium. Women should be carefully triaged and all other factors taken into account before further investigation are instigated.展开更多
Objective:Few studies have explored the suitability of endometrial thickness(EMT)as a predictor of ectopic pregnancy(EP)in frozen embryo transfer(FET)cycles.Our study aimed to investigate the association between EMT a...Objective:Few studies have explored the suitability of endometrial thickness(EMT)as a predictor of ectopic pregnancy(EP)in frozen embryo transfer(FET)cycles.Our study aimed to investigate the association between EMT and EP and explore the cutoff value of EMT to predict EP.Methods:This retrospective cohort study included women aged 20-45 years undergoing FET between March 2015 and September 2021.The primary outcomes and measured variables were EP and EMT,respectively.The threshold effect of EMT on EP was calculated based on a constructed smooth curve fitting.The patients were divided into two groups based on the threshold for comparison.A subgroup analysis was conducted to examine whether the relationship between EMT and EP remained consistent across the different subgroups.Additionally,a generalized linear model was used to analyze the interactions between the treatment factors and EMT in EP.Results:In total,27,549 FET cycles were included,with 27,086 intrauterine and 463 ectopic pregnancies.The risk of EP in the EMT≤8.7 mm group was 3.36 times higher than that in the EMT>8.7 mm group(odds ratio[OR]:3.36,95%confidence interval[CI]:2.57-4.05).Subgroup analysis further indicated that a thin EMT was a risk factor for EP,independent of other risks.We also noted that diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may further enhance the risk of EP in patients with thin endometrium.Conclusions:Thin endometrium was associated with an increased risk of EP.Patients with EMT less than 8.7 mm need close medical observation and management after embryo transfer.In addition,diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may significantly enhance the effect of a thin endometrium on the risk of EP.展开更多
Background Endometrial polyps （EPs） occur in approximately 34.9% of infertile women. Transvaginal sonography （TVS） is a routine, non-invasive component of fertility evaluation. Most ultrasonographic studies of EPs...Background Endometrial polyps （EPs） occur in approximately 34.9% of infertile women. Transvaginal sonography （TVS） is a routine, non-invasive component of fertility evaluation. Most ultrasonographic studies of EPs have focused on abnormal uterine bleeding; few have assessed EPs in infertile women. Furthermore, no studies have explored endometrial thickness and its correlation with EPs in infertile women. This study aimed to assess transvaginal sonographic assessment of endometrial thickness and its value in diagnosis and prediction of EPs in infertile women. Methods A retrospective study on 314 infertile women was conducted from June to December 2010. After TVS, endometrial biopsies were obtained by hysteroscopy. Pathologically confirmed EPs were taken as the gold standard. Results Based on recognized criteria, TVS had a sensitivity of 37.04%, specificity of 98.71%, positive predictive value of 90.91%, negative predictive value of 81.85%, and accuracy of 82.80% for diagnosing EPs. Mean endometrial thickness was significantly different in patients with and without EPs （P=0.0001）. In women in the mid and late-proliferative phase, the endometrial thickness was significantly greater in those with EPs than in those without them （P=0.0001 and 0.024）. Receiver operating characteristic analysis showed that endometrial thickness had a sensitivity of 85.2% and specificity of 38% in the diagnosis of EPs, the area under the curve being 0.64. In the mid-proliferative phase, sensitivity was up to 90.9%, the area under the curve being 0.70. Conclusions TVS is poor at detecting EPs in infertile women; however, transvaginal sonographic measurement of endometrial thickness is helpful. It is suggested that the diagnostic value of TVS for EPs in infertile women could be improved by adding the measurement of endometrial thickness to the variables that are routinely assessed.展开更多
目的探索子宫内膜的机械刺激是否可以改善胚胎移植失败患者的妊娠结局。方法采用计算机检索方法,收集中国科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、中国生物医学期刊数据库(CMCC)、中国医学学术会议论文数据库(CMAC)、中国知...目的探索子宫内膜的机械刺激是否可以改善胚胎移植失败患者的妊娠结局。方法采用计算机检索方法,收集中国科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、中国生物医学期刊数据库(CMCC)、中国医学学术会议论文数据库(CMAC)、中国知网(CNKI)、万方数据库以及Cochrane Library、PubMed、ProQuest Medical Library、Medline等外文生物医学期刊文献数据库以及手工检索国内相关妇产科杂志中关于机械损伤刺激子宫内膜对胚胎移植失败患者妊娠结局影响的随机对照试验及前瞻性研究文献,提取相关数据资料,并对所纳入文献进行系统评价,使用Revman 5.2软件进行Meta分析。结果共纳入6个研究,纳入946例患者,其中内膜机械损伤刺激组(试验组)451例,未刺激组(对照组)495例。Meta分析结果显示,试验组较对照组临床妊娠率有显著性提高,且两组差异有统计学意义[RR=1.74,95%CI(1.16-2.60),P=0.007];试验组与对照组比较活产率有提高,且差异亦有统计学意义[RR=1.44,95%CI(1.19-1.75),P=0.0002];试验组与对照组相比,两组流产率无显著性差异[RR=0.82,95%CI(0.47-1.42),P=0.47]。结论子宫内膜的机械损伤刺激可以提高胚胎移植失败患者的临床妊娠率、活产率,但不增加流产率。展开更多
基金Supported by a grant from the Medical and Health Technology Development Program in Shandong Province(No.2015WS0407)
文摘Objective This study aimed to combine tumor abnormal protein(TAP) and high-sensitivity C-reactive protein(hs-CRP) level detection to diagnose endometrial cancer in patients with endometrial thickness less than 8 mm, and to provide a reference for clinical screening and diagnosis. Methods Clinical data from 19 cases of endometrial cancer, diagnosed on the basis of pathological findings, were collected from September 2014 to December 2015. The inclusion criteria were as follows: the patients were first diagnosed with endometrial thickness less than 8 mm and were all in menopause. Perimenopausal patients(n = 26) with uterine fibroids seen during the same period were selected as a control group. Serum TAP and hs-CRP levels of the patients in the two groups were simultaneously determined on admission. Results We found that both TAP and hs-CRP levels in the experimental group were higher than those in the control group [(182.95 ± 72.14) μm^2 vs.(133.19 ± 55.18) μm^2, P = 0.019;(7.52 ± 19.03) mg/L vs.(1.66 ± 2.31) mg/L, P = 0.136]. The sensitivity of TAP for the diagnosis of endometrial cancer was 73.68%, the specificity was 69.23%, and the Youden index was 0.4291. The diagnostic sensitivity and specificity of hs-CRP was 15.79% and 100%, respectively, and the Youden index was 0.1579. After plotting the receiver operating characteristics curves, the optimal cut-off value for TAP in diagnosing endometrial cancer was found to be 160.662 μm^2 and that for hs-CRP was 1.07 mg/L. Conclusion For patients suspected of having endometrial cancer with endometrial thickness less than 8 mm, combined detection of TAP and hs-CRP levels can be used as a screening tool and can provide new ideas regarding clinical diagnosis and treatment.
文摘Background: Women with polycystic ovary syndrome (PCOS) are at higher risk of developing endometrial hyperplasia (EH). This study determined the prevalence of EH among women with infertility due to PCOS and assessed the predictive value of endometrial thickness (ET) measurement by trans-vaginal scan (TVS). Study Type & Population: This was a prospective study on infertile women with and without PCOS in which clinical data, hormonal profile, ET and endometrial biopsy (EB) for histopathological examination were collected. Methods: Thirty-seven women with PCOS and 23 women without PCOS presenting with infertility and/or abnormal uterine bleeding underwent TVS, hysteroscopy, laparoscopy and EB. Results: The overall prevalence of EH was 23.3 % while in PCOS group: 18.3 %. The mean ET (14.8 mm) was significantly higher in patients with EH (t = -2.74, P value = 0.009). The lower value of ET among women with EH was 10 mm. A cut-off point of 9.5 mm was set. An ET of >9.5 mm had 92.9% sensitivity and 51.85% specificity for the presence of EH. Women with ET ≥ 9.5 mm were 1.28 times more at risk of EH than women with ET 9.5 mm. Women with oligomenorrhea and irregular cycles were 5.5 and 13.7 times more at risk of EH compared to those with regular cycles, respectively. ET was positively correlated with insulin resistance (r = 0.439, P = 0.007). Conclusion: ET ≥ 9.5 mm predicts EH in infertile women with PCOS, with a high degree of sensitivity and a moderate degree of specificity. In PCOS patients with oligomenorrhea or irregular cycles, the risk of EH is higher than women with regular cycles.
文摘Background: Polycystic ovarian syndrome (PCOS) is considered the commonest endocrinological disorder affecting reproductive aged women. PCOS compromises fertility through various pathways. These pathways include hyperandrogenism, insulin resistance and impedance of the uterine and endometrial blood flow. Metformin improves the blood flow to the endometrium. It acts by reducing androgen level and correction of insulin resistance. Endometrial vascular indices were evaluated in this study to evaluate endometrial receptivity in anovulatory patients with PCOS. Aim of the Work: To evaluate the outcome of metformin administration in anovulatory patients with PCOS and its effect on the endometrium. This included its role in ovulation and improvement of pregnancy rates. Patients and Methods: This study included 85 patients from Ain Shams University outpatient infertility clinics from 1st of January, 2018 till 30th of June, 2018. We investigated these patients before treatment with ultrasound on day 14, 21. We evaluated endometrial thickness, uterine artery flow pattern, endometrial and subendometrial flow patterns. The patients received metformin 500 mg three times per day for three months. After this duration, we reevaluated them by ultrasound at days 14, 21. Results: Metformin therapy resulted in a significant increase of endometrial thickness and had a significant decrease on uterine, endometrial and subendometrial resistance index (R.I) and pulsatility index (P.I) at day 14, 21 compared to pre-treatment values indicating better blood flow. Conclusion: Metformin therapy resulted in improvement of endometrial flow patterns. Also, it resulted in increase in endometrial thickness and improvement of uterine artery flow.
文摘Background: Transvaginal color Doppler sonography of the uterine artery has been reported useful for evaluation of abnormal uterine bleeding in peri-/post-menopausal women. It may differentiate physiological from malignant endometrial changes. Objective: Evaluating the endometrial thickness and uterine artery Doppler as an initial diagnostic tool to identify patients with abnormal endometrial pathology. Methods: This is a prospective case control study consisted of total 50 women with peri-(n = 35) and post-(n = 15) menopausal bleeding, with 20 women consisting control group (no bleeding) (peri-(n = 10) and post-menopausal (n = 10)). Double layer endometrial thickness and uterine-artery-Doppler waveforms were measured, with the latter being S/D ratio, RI and PI. These were related to histological findings (endometrial biopsy). Result: Patients with abnormal uterine bleeding (both peri- and postmenopausal) had a significantly higher mean endometrial thickness than the control women. Study group showed a significantly lower value of all Doppler indices (S/D ratio, RI and PI). In study group, patients with malignant endometrial pathology showed significantly thicker endometrium and significantly lower Doppler indices than those with benign pathology. Conclusion: The combination of endometrial thickness and uterine artery color Doppler pattern might predict uterine endometrial malignancy, although whether it can discriminate (screen) patients requiring endometrial biopsy is not evident. Further study is needed.
基金the Guangdong Medical Science and Technology Research Foundation(No.A2021345).
文摘Endometrial receptivity is an important factor that influences embryo implantation.Thus,it is important to identify an applicable approach to improve endometrial receptivity in women undergoing assisted reproductive technology.Recently,growing evidence has indicated that intrauterine platelet-rich plasma(PRP)infusion is an effective method to obtain a satisfactory reproductive outcome by increasing endometrial thickness and improving endometrial receptivity.Therefore,the present review aims to outline the possible mechanisms of PRP on endometrial receptivity and summarize the present literature on the effects of PRP therapy in improving endometrial receptivity.
文摘Background: A thickened endometrium in the postmenopausal patient is a common reason for referral to gynaecology rapid access clinics under the cancer targets wait. This can often be an incidental finding in the asymptomatic patient. Investigation of this can be invasive, uncomfortable and carries significant surgical risk. Aims: This paper aims to summarise all the recent literature to see if there is any clear consensus on who should be further investigated in this select group of patients. Methods: Systematic literature review. Results: The studies varied greatly on the need for further investigation in asymptomatic women with endometrial thickness greater than 11 mm, with some deciding on careful case selection for further investigation, and others investigating every patient. The treatment of asymptomatic patients with endometrium classified as thickened, yet under 11 mm and no symptoms again varied in case selection and further investigation. Endometrial polyps were mentioned in 1 paper, suggesting that asymptomatic polyps need not be removed, which is contrary to current clinical practice. Conclusion: There is no overall opinion as to the exact treatment of women with thickened endometrium. Women should be carefully triaged and all other factors taken into account before further investigation are instigated.
基金National Natural Science Foundation of China(grant no.81971391)。
文摘Objective:Few studies have explored the suitability of endometrial thickness(EMT)as a predictor of ectopic pregnancy(EP)in frozen embryo transfer(FET)cycles.Our study aimed to investigate the association between EMT and EP and explore the cutoff value of EMT to predict EP.Methods:This retrospective cohort study included women aged 20-45 years undergoing FET between March 2015 and September 2021.The primary outcomes and measured variables were EP and EMT,respectively.The threshold effect of EMT on EP was calculated based on a constructed smooth curve fitting.The patients were divided into two groups based on the threshold for comparison.A subgroup analysis was conducted to examine whether the relationship between EMT and EP remained consistent across the different subgroups.Additionally,a generalized linear model was used to analyze the interactions between the treatment factors and EMT in EP.Results:In total,27,549 FET cycles were included,with 27,086 intrauterine and 463 ectopic pregnancies.The risk of EP in the EMT≤8.7 mm group was 3.36 times higher than that in the EMT>8.7 mm group(odds ratio[OR]:3.36,95%confidence interval[CI]:2.57-4.05).Subgroup analysis further indicated that a thin EMT was a risk factor for EP,independent of other risks.We also noted that diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may further enhance the risk of EP in patients with thin endometrium.Conclusions:Thin endometrium was associated with an increased risk of EP.Patients with EMT less than 8.7 mm need close medical observation and management after embryo transfer.In addition,diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may significantly enhance the effect of a thin endometrium on the risk of EP.
文摘Background Endometrial polyps （EPs） occur in approximately 34.9% of infertile women. Transvaginal sonography （TVS） is a routine, non-invasive component of fertility evaluation. Most ultrasonographic studies of EPs have focused on abnormal uterine bleeding; few have assessed EPs in infertile women. Furthermore, no studies have explored endometrial thickness and its correlation with EPs in infertile women. This study aimed to assess transvaginal sonographic assessment of endometrial thickness and its value in diagnosis and prediction of EPs in infertile women. Methods A retrospective study on 314 infertile women was conducted from June to December 2010. After TVS, endometrial biopsies were obtained by hysteroscopy. Pathologically confirmed EPs were taken as the gold standard. Results Based on recognized criteria, TVS had a sensitivity of 37.04%, specificity of 98.71%, positive predictive value of 90.91%, negative predictive value of 81.85%, and accuracy of 82.80% for diagnosing EPs. Mean endometrial thickness was significantly different in patients with and without EPs （P=0.0001）. In women in the mid and late-proliferative phase, the endometrial thickness was significantly greater in those with EPs than in those without them （P=0.0001 and 0.024）. Receiver operating characteristic analysis showed that endometrial thickness had a sensitivity of 85.2% and specificity of 38% in the diagnosis of EPs, the area under the curve being 0.64. In the mid-proliferative phase, sensitivity was up to 90.9%, the area under the curve being 0.70. Conclusions TVS is poor at detecting EPs in infertile women; however, transvaginal sonographic measurement of endometrial thickness is helpful. It is suggested that the diagnostic value of TVS for EPs in infertile women could be improved by adding the measurement of endometrial thickness to the variables that are routinely assessed.
文摘目的探索子宫内膜的机械刺激是否可以改善胚胎移植失败患者的妊娠结局。方法采用计算机检索方法,收集中国科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、中国生物医学期刊数据库(CMCC)、中国医学学术会议论文数据库(CMAC)、中国知网(CNKI)、万方数据库以及Cochrane Library、PubMed、ProQuest Medical Library、Medline等外文生物医学期刊文献数据库以及手工检索国内相关妇产科杂志中关于机械损伤刺激子宫内膜对胚胎移植失败患者妊娠结局影响的随机对照试验及前瞻性研究文献,提取相关数据资料,并对所纳入文献进行系统评价,使用Revman 5.2软件进行Meta分析。结果共纳入6个研究,纳入946例患者,其中内膜机械损伤刺激组(试验组)451例,未刺激组(对照组)495例。Meta分析结果显示,试验组较对照组临床妊娠率有显著性提高,且两组差异有统计学意义[RR=1.74,95%CI(1.16-2.60),P=0.007];试验组与对照组比较活产率有提高,且差异亦有统计学意义[RR=1.44,95%CI(1.19-1.75),P=0.0002];试验组与对照组相比,两组流产率无显著性差异[RR=0.82,95%CI(0.47-1.42),P=0.47]。结论子宫内膜的机械损伤刺激可以提高胚胎移植失败患者的临床妊娠率、活产率,但不增加流产率。
