摘要
目的:系统评价在控制性超促排卵(COH)过程中使用褪黑素对辅助生殖助孕的有效性。方法:检索PubMed、Embase、The Cochrane Library、中国知网、维普、万方数据库及中国生物医学数据库公开发表的全部文献,检索时间是自建库至2020年1月。纳入关于COH过程中使用褪黑素治疗与辅助生殖治疗结局的随机对照试验(RCT),由两位评价员根据纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果:共纳入6篇RCT研究,共767个周期,褪黑素组419个周期,对照组348个周期。褪黑素组人绒毛膜促性腺激素(hCG)日雌二醇(E2)水平、MⅡ期卵母细胞数、优质胚胎数比对照组高,差异有统计学意义(均P<0.05)。褪黑素组临床妊娠率高,但差异无统计学意义(WMD=1.34,P=0.08,95%CI:0.96~1.86)。而2组患者的获卵数、受精率、移植胚胎数、流产率比较差异均无统计学意义(P>0.05)。结论:在辅助生殖助孕COH过程中添加褪黑素可以增加成熟卵和优质胚胎数,且临床妊娠率可能有所改善,该结论仍需更多的大样本量、多中心的RCT研究加以证实。
Objective:To evaluate the effectiveness of melatonin supplementation during controlled ovarian hyperstimulation for women undergoing assisted reproductive technology.Methods:We searched PubMed,Embase,the Cochrane Library,the CNKI Database,VIP Database,Wanfang Database and the Chinese Biomedicine(CBM)Database for eligible studies published by the end of January 2020.Two independent evaluators screened the randomized controlled trials retrieved the effects of melatonin supplementation during controlled ovarian hyperstimulation in women undergoing assisted reproductive technology.The quality of the included studies was assessed,and the data were extracted for meta-analysis using RevMan 5.3.Results:A total of 6 RCTs involving 767 cycles were included.Among them,419 cycles were in the melatonin group and 348 cycles in the control group.The meta-analysis showed that the numbers of MⅡoocytes,high-quality embryos and the E2 levels on hCG day in the melatonin group was significantly higher than those in the control group(P<0.05).The melatonin supplementation during controlled ovarian hyperstimulation moderately elevated the clinical pregnancy rate,but the difference was not significant(WMD=1.34,P=0.08,95%CI:0.96-1.86).However,there were no significant differences in the number of oocytes retrieved and embryos transplanted,fertilization rate and abortion rate between the two groups(P>0.05).Conclusions:The currently available evidence suggests that melatonin supplementation during controlled ovarian hyperstimulation for women undergoing assisted reproductive technology can improve the numbers of MⅡoocytes and high-quality embryos,and clinical pregnancy rate.Larger sample size and multicenter RCTs are needed to verify the above conclusions.
作者
周丽媛
文壹
唐君
康革华
毛增辉
ZHOU Li-yuan;WEN Yi;TANG Jun;KANG Ge-hua;MAO Zeng-hui(Reproductive Center,Changsha Hospital for Maternal and Child Health Care,Changsha 410007,China;Reproductive Center,Human Provincial Maternal and Child Health Care Hospital,Changsha 410007,China)
出处
《国际生殖健康／计划生育杂志》
CAS
2021年第1期11-17,共7页
Journal of International Reproductive Health/Family Planning
关键词
生殖技术
辅助
褪黑激素
排卵诱导
随机对照试验
META分析
Reproductive techniques,assisted
Melatonin
Ovulation induction
Randomized controlled trial
Meta-analysis
