提高活產率

出處:第一名的不孕症期刊

 

Hum Reprod Update. 2011年7月6日 搶鮮版

促性腺激素釋放激素激動劑觸發(GnRHa)用於試管嬰兒療程黃體支持以提高活產率的系統評價和綜整分析

 

來自希臘的研究 

摘要 
本系統評價和綜整分析，以評估是否對促性腺激素釋放激素激動劑觸發(GnRHa)用於黃體支持ICSI / IVF週期提高活產的概率。方法文獻檢索系統（MEDLINE，EMBASE，中央和登記 RCT）進行，以確定相關的隨機對照試驗的全部手稿出版。 Meta分析得出的數據匯集風險差異（RDS）和95％可信區間（CI）。隨機效應模型應用於池的研究。結果確定了六個相關隨機對照試驗共包括2012的患者。概率的活產率（RD：16％，95％CI：+10至+22％）顯著的病人接受促性腺激素釋放激素激動劑觸發(GnRHa)的高於那些沒有使用者。該小組分析根據類型的GnRH類似物用於 LH抑制並沒有改變效果觀察（促性腺激素釋放激素激動劑觸發(GnRHa)的研究中，期間使用了卵巢刺激，RD：15％，95％CI：+5至+23％）;研究中GnRH拮抗劑期間使用了卵巢刺激，RD：+19％，95％CI：+11至+27％）。結論現有的最佳證據表明，促性腺激素釋放激素激動劑觸發(GnRHa)在黃體期顯著增加的活產率。 

 

PS: 促性腺激素釋放激素激動劑觸發(GnRHa)的角色多彩多姿。豐富了人工生殖的應用。目前促性腺激素釋放激素激動劑觸發(GnRHa)用於調控刺激排卵前或中對腦下垂體及卵巢的性腺荷爾蒙的影響。也用於取代破卵針於PCOS或預防OHSS的功能。本篇令人有興趣的是系統性評價和綜整分析促性腺激素釋放激素激動劑觸發(GnRHa)用於取卵或排卵以後的黃體期,是因GnRHa激動劑的機制對胚胎和子宮內膜也有直接影響且有益影響黃體期而增加活產率。

 

 

 

 

Hum Reprod Update. 2011 Jul 6. [Epub ahead of print]

Increased live birth rates with GnRH agonist addition for luteal support in ICSI/IVF cycles: a systematic review and meta-analysis.

Kyrou D, Kolibianakis EM, Fatemi HM, Tarlatzi TB, Devroey P, Tarlatzis BC.

Source

Unit for Human Reproduction, Department of Obstetrics and Gynaecology, Medical School, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Nea Efkarpia Peripheral Road, Thessaloniki 54603, Greece.

Abstract

BACKGROUND The aim of this systematic review and meta-analysis was to evaluate whether the addition of GnRH agonist for luteal support in ICSI/IVF cycles enhances the probability of live birth. METHODS Systematic literature search (MEDLINE, EMBASE, CENTRAL and RCT registries) was conducted to identify relevant randomized controlled trials published as full manuscripts. Meta-analysis of data yielded pooled risk differences (RDs) and 95% confidence intervals (CIs). A random effects model was applied for pooling the studies. RESULTS Six relevant RCTs were identified including a total of 2012 patients. The probability of live birth rate (RD: +16%, 95% CI: +10 to +22%) was significantly higher in patients who received GnRH agonist support compared with those who did not. The subgroup analysis according to the type of GnRH analogue used for LH suppression did not change the effect observed (studies in which GnRH agonist was used during ovarian stimulation, RD: +15%, 95% CI: +5 to +23%); (studies in which GnRH antagonist was used during ovarian stimulation, RD: +19%, 95% CI: +11 to +27%). CONCLUSIONS The best available evidence suggests that GnRH agonist addition during the luteal phase significantly increases the probability of live birth rates.