The effect of endometriosis on in vitro fertilisation outcome: a systematic review and meta-analysis
The effect of endometriosis on in vitro fertilisation outcome: a systematic review and meta-analysis
复制标题
DOI：
10.1111/1471-0528.12366
复制
发表时间：
2013-10-01
影响因子：
5.8
通讯作者：
Coomarasamy, A.
中科院分区：
文献类型：
--
作者：
Harb, H. M.;Gallos, I. D.;Coomarasamy, A.
背景子宫内膜异位症发生于0.5-5%的生育妇女和25-40%的不孕妇女。目的探讨子宫内膜异位症与体外受精（IVF）结局的相关性，并通过MEDLINE、EMBASE、科克伦图书馆和Web of Science进行检索（Inception，December 2012）在所有语言中，连同检索到的论文的参考列表。选择标准子宫内膜异位症女性与非子宫内膜异位症女性的IVF结局比较研究。患者按子宫内膜异位症分期进行分类。结果包括受精、着床、临床妊娠和活产率。研究选择由两名评审员独立进行。采用Newcastle-Ottawa质量评估量表进行质量评估。数据收集和分析数据提取由两名评价者独立进行。从个别研究的相对风险进行了meta analysed.Main resultsTwenty-seven观察性研究，包括8984名妇女。这些研究的荟萃分析显示，I/II期子宫内膜异位症的受精率降低（相对危险度[RR]=0.93，95%置信区间[95% CI] 0.87-0.99，P=0.03）。着床率下降（RR=0.79，95%CI 0.67-0.93，P=0.006）和临床妊娠率（RR=0.79，95% CI 0.69-0.91，P=0.0008）在接受IVF治疗的III/IV期子宫内膜异位症妇女中。（III/IV期）与接受IVF治疗的女性的植入率和临床妊娠率相关。
BackgroundEndometriosis is found in 0.5-5% of fertile women and 25-40% of infertile women. It is known that endometriosis is associated with infertility, but there is uncertainty whether women with endometriosis have adverse pregnancy outcomes in in vitro fertilisation (IVF) treatment.ObjectivesTo explore the association between endometriosis and IVF outcome.Search strategySearches were conducted on MEDLINE, EMBASE, Cochrane Library and Web of Science (inception, December 2012) in all languages, together with reference lists of retrieved papers.Selection criteriaStudies comparing IVF outcome in women with endometriosis with women without endometriosis. Patients were classified by stage of endometriosis. The outcomes were fertilisation, implantation, clinical pregnancy and live birth rates. Study selection was conducted independently by two reviewers. The Newcastle-Ottawa Quality Assessment Scale was used for quality assessment.Data collection and analysisData extraction was conducted independently by two reviewers. Relative risks from individual studies were meta-analysed.Main resultsTwenty-seven observational studies were included, comprising 8984 women. Meta-analysis of these studies showed that fertilisation rates were reduced in stage I/II of endometriosis (relative risk [RR]=0.93, 95% confidence interval [95% CI] 0.87-0.99, P=0.03). There was a decrease in the implantation rate (RR=0.79, 95% CI 0.67-0.93, P=0.006) and clinical pregnancy rate (RR=0.79, 95% CI 0.69-0.91, P=0.0008) in women with stage III/IV endometriosis undergoing IVF treatment.ConclusionThe presence of severe endometriosis (stage III/IV) is associated with poor implantation and clinical pregnancy rates in women undergoing IVF treatment.