中药在辅助生育技术IVF-ET中干预卵巢过度刺激综合症发生及妊娠结局的Meta分析

Meta-Analysis of Traditional Chinese Medicine in the Intervention of Ovarian Hyperstimulation Syndrome and Pregnancy Outcome in Assisted Reproductive Technology IVF-ET

摘要: 目的：系统评价中药在辅助生育技术IVF-ET中干预卵巢过度刺激综合症发生及妊娠结局。方法：电子检索PubMed、Cochrane Library、Web of Science、中国知网数据库和万方数据库，检索自建库至2022年5月发表有关中药在辅助生育技术(IVF-ET)中干预卵巢过度刺激综合症发生及其妊娠结局的随机对照试验。按照既定的纳入及排除标准筛选文献，并对所纳入文献研究进行质量评价及提取数据，再以Review Manager 5.4.1软件进行Meta分析。结果：纳入14篇文献研究，共1854例。Meta分析显示：中药组在辅助生育技术IVF-ET中减低卵巢过度刺激综合症的发生优于对照组(OR = 0.32, 95% CI [0.24, 0.42], P < 0.00001)；中药干预亦有效控制IVF-ET中的获卵数目(MD = −2.21, 95% CI [−4.03, −0.39], P = 0.02)，而中药组的临床妊娠率较对照组高(OR = 1.68, 95% CI [1.31, 2.16], P < 0.0001)。结论：中药在辅助生育技术IVF-ET中有效减低卵巢过度刺激综合症发生，控制(降低)IVF-ET中的获卵数目，并提高临床妊娠率。但纳入研究质量偏低、疗效评价标准不一，尚需更多高质量、多中心的随机双盲试验，以进一步支持上述结论。

Abstract: Objective: To systematically evaluate the effect of Chinese medicines on the incidence of ovarian hyperstimulation syndrome (OHSS) and pregnancy outcomes of patients undergoing in vitro fertilization and embryo transplantation (IVF-ET). Methods: Databases such as PubMed, Cochrane Library, Web of Science, CNKI and Wanfang database were searched to collect the randomized clinical trials about the effect of Chinese medicines on the incidence of OHSS and pregnancy outcomes of patients undergoing IVF-ET from the establishment of the database to May 2022. The literatures were screened according to the inclusion and exclusion criteria. The selected literatures underwent quality evaluation prior to data extraction. Then carry out meta-analysis which was performed by using Review Manager 5.4.1. Results: 14 literatures were included in this study, there were 1854 cases in total. The result of meta analysis showed that the effect of lowering the incidence of OHSS was more significant in Chinese medicines group than that of the control group (OR = 0.32, 95% CI [0.24, 0.42], P < 0.00001); Intervention of Chinese medicine could effectively control the number of oocytes retrieved in IVF-ET (MD = −2.21, 95% CI [−4.03, −0.39], P = 0.02). The clinical pregnancy rate in Chinese medicine group was higher than that of control group (OR = 1.68, 95% CI [1.31, 2.16], P < 0.0001). Conclusion: Using Chinese medicine in IVF-ET, it can effectively reduce the incidence of ovarian hyperstimulation syndrome, control (lower) the number of oocytes retrieved; and enhance the clinical pregnancy rate. However, for the poor quality of included RCTs and unstandardized evaluation standards, more randomized-double-blind trials with high quality and multicenter are needed to support the above mentioned conclusion.