Background： Luteal support is a key to patients undergoing in vitro fertilization and embryo transfer （IVF-ET） with gonadotropin-releasing hormone （GnRH）-antagonist protocol. This study aimed to compare the effec...Background： Luteal support is a key to patients undergoing in vitro fertilization and embryo transfer （IVF-ET） with gonadotropin-releasing hormone （GnRH）-antagonist protocol. This study aimed to compare the effect between vaginal progesterone （VP） and intramuscular progesterone （IMP） with GnRH-antagonist protocol alter IVF-ET. Methods： A total of 1760 patients （18 years ≤ age ≤35 years） undergoing IVF-ET with GnRH-antagonist protocol were studied retrospectively between September 2014 and August 2015 in Peking University Third Hospital. In the patients, 1341 patients received VP （VP group） and 419 patients received IMP （IMP group） as luteal support. We compared clinical outcomes between these two groups. The primary objective of the study was the live birth rate. Measurement data between the two groups were conducted using independent samples t-test. The variables in line with non-normal distribution were expressed as median （p25 and p75） and were compared using nonparametric Mann. Whitney U-test. Results： Live birth rate in VP group was 38.55%, significantly higher than that in the IMP group, which was 30.79% （x^2 = 8.287, P= 0.004）. The clinical intrauterine pregnancy rate and implantation rate in VP group were also significantly higher than those in the IMP group （clinical intrauterine pregnancy rate 47.35% vs. 41.29%, x^2= 4.727, P = 0.030： implantation rate 30.99% vs. 25.26%, x^2=14.546, P 〈 0.001）. Any statistically significant differences in ectopic pregnancy and abortion rates between two groups were not observed. Conclusion： Luteal support with VP had better clinical outcomes for young women undergoing IVF-ET with GnRH-antagonist protocol.展开更多
Objective:To evaluate the clinical effect of acupuncture-moxibustion as the adjuvant therapy on frozenthawed embryo transfer(FET)using network meta-analysis.Methods:In PubMed,Embase,Cochrane Library,Chinese National K...Objective:To evaluate the clinical effect of acupuncture-moxibustion as the adjuvant therapy on frozenthawed embryo transfer(FET)using network meta-analysis.Methods:In PubMed,Embase,Cochrane Library,Chinese National Knowledge Infrastructure(CNKI),Wanfang database(WanFang),VIP database and Chinese Biomedical Literature Database(SinoMed),the randomized controlled trials(RCTs)of the adjuvant therapy of acupuncture-moxibustion for FET were retrieved,from database inception to April 1,2021.Cochrane risk of bias assessment tool was used to screen and evaluate the quality of the included studies,and RevMan 5.3,GeMTC0.14.3 and Stata16.0 software were adopted to complete the network meta-analysis.Results:Twenty-nine RCTs comprising 2880 patients were finally included,involving 17 interventions and 4 outcome measures.The results of network meta-analysis showed that the top three therapies under each outcome based on the magnitude of SUCRA values were:(1)Clinical pregnancy rate(CPR,%):"transcutaneous electrical acupoint stimulation+herbal medicine"(76.4),"moxibustion+herbal medicine"(74.7),"acupuncture+moxibustion"(73.3);(2)Biochemical pregnancy rate(BPR):"moxibustion+herbal medicine"(89.3),"acupuncture+moxibustion"(82.1),"acupuncture+herbal medicine"(78.7);(3)Endometrial thickness:"acupoint injection+Western medicine"(87.2),auricular therapy(76.8),"acupuncture+herbal medicine"(73.5);(4)Type A endometrial morphology rate:"acupoint injection+Western medicine"(78.3),"moxibustion+herbal medicine"(58.0)and"acupuncture+moxibustion"(52.6).Conclusion:The combined treatment of acupuncture-moxibustion was superior to single therapy for FET patients.The combined therapy of transcutaneous electrical acupoint stimulation and herbal medicine had the best effect for improving CPR,"moxibustion+herbal medicine"obtained the best average comprehensive effect,and"acupoint injection+Western medicine"was conductive to ameliorate the endome trial thickness and morphology.Due to the limitations of existing studies,more high-quality RCTs are neede展开更多
基金This study was supported by a grant from the National Natural Science Foundation of Key Program （No. 31230047）.
文摘Background： Luteal support is a key to patients undergoing in vitro fertilization and embryo transfer （IVF-ET） with gonadotropin-releasing hormone （GnRH）-antagonist protocol. This study aimed to compare the effect between vaginal progesterone （VP） and intramuscular progesterone （IMP） with GnRH-antagonist protocol alter IVF-ET. Methods： A total of 1760 patients （18 years ≤ age ≤35 years） undergoing IVF-ET with GnRH-antagonist protocol were studied retrospectively between September 2014 and August 2015 in Peking University Third Hospital. In the patients, 1341 patients received VP （VP group） and 419 patients received IMP （IMP group） as luteal support. We compared clinical outcomes between these two groups. The primary objective of the study was the live birth rate. Measurement data between the two groups were conducted using independent samples t-test. The variables in line with non-normal distribution were expressed as median （p25 and p75） and were compared using nonparametric Mann. Whitney U-test. Results： Live birth rate in VP group was 38.55%, significantly higher than that in the IMP group, which was 30.79% （x^2 = 8.287, P= 0.004）. The clinical intrauterine pregnancy rate and implantation rate in VP group were also significantly higher than those in the IMP group （clinical intrauterine pregnancy rate 47.35% vs. 41.29%, x^2= 4.727, P = 0.030： implantation rate 30.99% vs. 25.26%, x^2=14.546, P 〈 0.001）. Any statistically significant differences in ectopic pregnancy and abortion rates between two groups were not observed. Conclusion： Luteal support with VP had better clinical outcomes for young women undergoing IVF-ET with GnRH-antagonist protocol.
基金Supported by TCM Evidence-Based Capacity Construction Project,National Administration of Traditional Chinese Medicine,2019:2019XZZX-ZJ007National Key Research and Development Program:2019YFC1709104。
文摘Objective:To evaluate the clinical effect of acupuncture-moxibustion as the adjuvant therapy on frozenthawed embryo transfer(FET)using network meta-analysis.Methods:In PubMed,Embase,Cochrane Library,Chinese National Knowledge Infrastructure(CNKI),Wanfang database(WanFang),VIP database and Chinese Biomedical Literature Database(SinoMed),the randomized controlled trials(RCTs)of the adjuvant therapy of acupuncture-moxibustion for FET were retrieved,from database inception to April 1,2021.Cochrane risk of bias assessment tool was used to screen and evaluate the quality of the included studies,and RevMan 5.3,GeMTC0.14.3 and Stata16.0 software were adopted to complete the network meta-analysis.Results:Twenty-nine RCTs comprising 2880 patients were finally included,involving 17 interventions and 4 outcome measures.The results of network meta-analysis showed that the top three therapies under each outcome based on the magnitude of SUCRA values were:(1)Clinical pregnancy rate(CPR,%):"transcutaneous electrical acupoint stimulation+herbal medicine"(76.4),"moxibustion+herbal medicine"(74.7),"acupuncture+moxibustion"(73.3);(2)Biochemical pregnancy rate(BPR):"moxibustion+herbal medicine"(89.3),"acupuncture+moxibustion"(82.1),"acupuncture+herbal medicine"(78.7);(3)Endometrial thickness:"acupoint injection+Western medicine"(87.2),auricular therapy(76.8),"acupuncture+herbal medicine"(73.5);(4)Type A endometrial morphology rate:"acupoint injection+Western medicine"(78.3),"moxibustion+herbal medicine"(58.0)and"acupuncture+moxibustion"(52.6).Conclusion:The combined treatment of acupuncture-moxibustion was superior to single therapy for FET patients.The combined therapy of transcutaneous electrical acupoint stimulation and herbal medicine had the best effect for improving CPR,"moxibustion+herbal medicine"obtained the best average comprehensive effect,and"acupoint injection+Western medicine"was conductive to ameliorate the endome trial thickness and morphology.Due to the limitations of existing studies,more high-quality RCTs are neede
