摘要
目的系统评价卵裂期与囊胚期鲜胚移植后单卵双胎的发生率。方法计算机检索Cochrane library、PubMed、Embase、随机对照试验注册中心、中国生物医学文献数据库、中国知网数据库及万方医学数据库中2017年5月前发表的所有原创性研究论文,2位研究者根据纳入及排除标准独立对文献进行筛选、资料提取和质量评价后,采用Stata 12.0软件进行Meta分析。结果共纳入18篇文献。Meta分析结果显示,囊胚期鲜胚移植的单卵双胎率显著高于卵裂期鲜胚移植(P<0.05)。亚组分析表明,任何研究时期(无论是2002年前还是2002年后),囊胚移植的单卵双胎率均显著高于卵裂期胚胎移植(均P<0.05);基于不同地域分析结果表明,亚洲和美洲人群囊胚移植的单卵双胎率均显著高于卵裂期胚胎移植(均P<0.05),而在欧洲人群中两者则无明显差异(P>0.05);关于研究类型,回顾性研究中囊胚移植的单卵双胎率显著高于卵裂期胚胎移植(均P<0.05),而在前瞻性随机对照研究中则无明显差异(P>0.05)。结论与卵裂期鲜胚移植相比,囊胚期鲜胚移植的单卵双胎发生率更高。
Objective To evaluate the rate of monozygotic twinning（MZT）in fresh embryo transfer at cleavage stage and blastocyst stage. Methods The relevant papers published before May 2017 were electronically searched in Cochrane library,PubMed,Embase,WHO ICTRP,ClinicalTrials.gov,CNKI,CBM and WanFang database.Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data and assessed quality.Then,meta-analysis was performed using Stata 12.0 software. Results Eighteen studies were scrutinized for this meta-analysis.There was significantly higher rate of MZT at blastocyst stage fresh embryo transfer（P〈0.05）.The subgroup analysis showed that the rate of MZT at blastocyst stage fresh embryo transfer was significantly higher than that in cleavage stage embryos in different study periods（both before 2002 and after 2002）（P〈0.05,respectively）.For different regions,the analysis showed that the rates of MZT at blastocyst stage fresh embryo transfer in Asian and American populations were significantly higher than those in cleavage stage embryos（P〈0.05,respectively）,while there was no significant difference among European populations（P〉0.05）.For study types,the results demonstrated that the rate of MZT at blastocyst stage fresh embryo transfer was significantly higher than that in cleavage stage embryos in retrospective studies（P〈 0.05）,but no significant difference in prospective randomized controlled trials（P〉0.05）. Conclusions Compared with fresh embryo transfer at cleavage stage,blastocyst stage fresh embryo transfer was associated with a significantly higher rate of MZT.
作者
尹太郎
丁锦丽
张怡
敖良飞
罗金
李洁
兖娜娜
杨菁
YIN Tai-lang;DING Jin-li;ZHANG Yi;AO Liang-fei;LUO Jin;LI Jie;YAN Na-na;YANG Jing(Reproductive Medical Center,Renmin Hospital of Wuhan Universit;Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development,Wuhan 430060,China)
出处
《现代泌尿生殖肿瘤杂志》
2018年第3期166-172,共7页
Journal of Contemporary Urologic and Reproductive Oncology
基金
国家自然科学基金(81401276)
关键词
卵裂期
囊胚期
鲜胚移植
单卵双胎
META分析
Cleavage stage
Blastocyst stage
Fresh embryo transfer
Monozygotic twinning
Meta analysis
