Corifollitropin alfa for ovarian stimulation in in vitro fertilization: a systematic review and meta-analysis of randomized controlled trials
Corifollitropin alfa for ovarian stimulation in in vitro fertilization: a systematic review and meta-analysis of randomized controlled trials
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DOI：
10.1016/j.fertnstert.2018.11.047
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发表时间：
2019-04-01
影响因子：
6.7
通讯作者：
Garcia-Velasco, Juan Antonio
中科院分区：
文献类型：
--
作者：
Cozzolino, Mauro;Vitagliano, Amerigo;Garcia-Velasco, Juan Antonio
目的：评价促皮质激素α在提高IVF成功率方面的有效性。设计：系统回顾和荟萃分析。设置：不适用。患者：接受常规IVF或卵胞浆内单精子注射（ICSI）的不孕妇女。干预措施：接受单次IVF的不孕妇女的随机对照试验（RCT）/ICSI周期使用Corifollitropin alfa或基于每日注射的常规卵巢刺激方案。在开始数据提取之前，审查方案在PROSPERO中注册（CRD 42018088605）。主要结局指标：主要结局为活产率和/或持续妊娠率。临床妊娠率、流产率、多胎妊娠、获得的卵母细胞和胚胎数、取消率、卵巢过度刺激综合征和异位妊娠率被认为是次要outcome. Results（s）：8项随机对照试验被纳入; 2,345名妇女被分配到干预组，1,995名妇女被分配到对照组。对4，340个IVF周期的分析未显示组间活产率和/或持续妊娠率的任何差异（风险比[RR]，0.92; 95%置信区间[CI]，0.80-1.05）。同样，临床妊娠率（RR，0.96; 95% CI，0.88-1.05; I-2 = 0%）、流产率（RR，0.94; 95% CI，0.71-1.25; I-2 = 0%）或多胎妊娠率（RR，1.22; 95% CI，0.99-1.50; I-2 = 0%）也无差异。此外，两组的周期取消率、卵巢过度刺激综合征和异位妊娠率相似。敏感性和亚组分析没有提供统计学变化汇总results. Conclusions（S）：Corifollitropin阿尔法似乎是一种替代方案，每天重组FSH注射在正常和不良反应患者接受卵巢刺激IVF/ICSI治疗周期。((C)2018年美国生殖医学会（American Society for Reproductive Medicine）
Objective: To evaluate the effectiveness of corifollitropin alfa in improving the success of IVF.Design: Systematic review and meta-analysis.Setting: Not applicable.Patient(s): Infertile women undergoing conventional IVF or intracytoplasmic sperm injection (ICSI).Intervention(s): Randomized controlled trials (RCTs) of infertile women undergoing a single IVF/ICSI cycle with either corifollitropin alfa or a conventional ovarian stimulation protocol based on daily injections. The review protocol was registered in PROSPERO before starting the data extraction (CRD42018088605).Main Outcome Measure(s): Primary outcomes were live birth rate and/or ongoing pregnancy rate. Clinical pregnancy rate, miscarriage rate, multiple pregnancies, number of oocytes and embryos obtained, cancellation rate, and rate of ovarian hyperstimulation syndrome and ectopic pregnancy were considered as secondary outcomes.Result(s): Eight randomized controlled trials were included; 2,345 women were assigned to the intervention group and 1,995 to the control group. The analysis of 4,340 IVF cycles did not reveal any difference in live birth rate and/or ongoing pregnancy rate between groups (risk ratio [RR], 0.92; 95% confidence interval [CI], 0.80-1.05). Similarly, no difference was found in clinical pregnancy rate (RR, 0.96; 95% CI, 0.88-1.05; I-2 = 0%), miscarriage rate (RR, 0.94; 95% CI, 0.71-1.25; I-2 = 0%), or multiple pregnancy rate (RR, 1.22; 95% CI, 0.99-1.50; I-2 = 0%). Also, the rates of cycle cancellation, ovarian hyperstimulation syndrome, and ectopic pregnancy were similar in both groups. Sensitivity and subgroup analyses did not provide statistical changes to pooled results.Conclusion(s): Corifollitropin alfa seems to be an alternative for daily recombinant FSH injections in normal and poor responder patients undergoing ovarian stimulation in IVF/ICSI treatment cycles. ((C) 2018 by American Society for Reproductive Medicine.)