The effect of intramural fibroids without uterine cavity involvement on the outcome of IVF treatment: a systematic review and meta-analysis
The effect of intramural fibroids without uterine cavity involvement on the outcome of IVF treatment: a systematic review and meta-analysis
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DOI：
10.1093/humrep/dep396
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发表时间：
2010-02-01
影响因子：
6.1
通讯作者：
Coomarasamy, Arri
中科院分区：
文献类型：
--
作者：
Sunkara, Sesh Kamal;Khairy, Mohammed;Coomarasamy, Arri
子宫肌瘤对生育能力的影响知之甚少。粘膜下和肌壁间肌瘤扭曲子宫内膜腔与IVF治疗后妊娠率（PR）下降有关。然而，不扭曲子宫内膜腔的壁间肌瘤对IVF结局的影响还不确定，我们对研究进行了系统回顾和荟萃分析，以评估非腔扭曲壁间肌瘤与IVF结局之间的关系。检索MEDLINE、EMBASE、科克伦图书馆和Web of Science。研究选择和数据提取由两名评审员独立进行。使用Newcastle-Ottawa质量评估量表进行质量评估。如果合适的话，进行荟萃分析。我们确定了19项观察性研究，包括6087个IVF周期。这些研究的荟萃分析显示，活产率显著下降，（RR = 0.79，95%CI：0.70-0.88，P < 0.0001）和临床PR（RR = 0.85，95% CI：0.77-0.94，P = 0.002），与无肌瘤的女性相比，非腔扭曲壁间肌瘤的存在与经历IVF治疗的妇女的不良妊娠结果相关。
The influence of fibroids on fertility is poorly understood. Submucosal and intramural fibroids that distort the endometrial cavity have been associated with decreased pregnancy rates (PRs) following IVF treatment. However, there is uncertainty about the effect of intramural fibroids that do not distort the endometrial cavity on IVF outcomes.We conducted a systematic review and meta-analysis of studies to evaluate the association between non-cavity-distorting intramural fibroids and IVF outcome. Searches were conducted on MEDLINE, EMBASE, Cochrane Library and Web of Science. Study selection and data extraction were conducted independently by two reviewers. The Newcastle-Ottawa Quality Assessment Scales were used for quality assessment. Meta-analysis was performed if appropriate.We identified 19 observational studies comprising 6087 IVF cycles. Meta-analysis of these studies showed a significant decrease in the live birth (RR = 0.79, 95% CI: 0.70-0.88, P < 0.0001) and clinical PRs (RR = 0.85, 95% CI: 0.77-0.94, P = 0.002) in women with non-cavity-distorting intramural fibroids compared with those without fibroids, following IVF treatment.The presence of non-cavity-distorting intramural fibroids is associated with adverse pregnancy outcomes in women undergoing IVF treatment.