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目的:评价黄体酮肌肉注射和阴道缓释凝胶(Crinone 8%)2种给药途径对体外受精-胚胎移植(IVF-ET)结局的影响。方法:计算机检索Pub Med、EMbase、Cochrane图书馆、中国知网和万方。收集2种给药途径的随机对照试验(RCT),提取有效数据后采用Rev Man 5.1软件进行Meta分析。结果:纳入10个随机对照试验,共计2 528例患者,其中肌肉注射组1 331例,阴道缓释凝胶组1 197例。Meta分析结果显示:阴道缓释凝胶组和肌肉注射组的临床妊娠率(OR=0.93,95%CI=0.79~1.09,P=0.35)、继续妊娠率(OR=0.88,95%CI=0.64~1.21,P=0.43)、流产率(OR=0.75,95%CI=0.52~1.08,P=0.12)无统计学差异。结论:黄体酮肌肉注射和阴道缓释凝胶对IVF-ET后的临床妊娠率、继续妊娠率及流产率无显著影响。
OBJECTIVE: To evaluate the effects of two routes of administration of progesterone and vaginal sustained-release gel (Crinone 8%) on the outcome of IVF-ET. METHODS: We searched Pub Med, EMbase, Cochrane Library, CNKI and Wanfang. Randomized controlled trials (RCTs) of two routes of administration were collected, validated data were extracted and Meta-analysis was performed using Rev Man 5.1 software. Results: A total of 2258 patients were enrolled in 10 RCTs, including 1 331 in the intramuscular group and 1 197 in the vaginal sustained-release gel group. The results of Meta-analysis showed that the clinical pregnancy rate (OR = 0.93, 95% CI = 0.79-1.09, P = 0.35) and the pregnancy rate (OR = 0.88, 95% CI = 0.64 ~ 1.21, P = 0.43), abortion rate (OR = 0.75,95% CI = 0.52 ~ 1.08, P = 0.12) was not statistically significant. CONCLUSION: Intravenous injection of progesterone and vaginal sustained release gel have no significant effect on clinical pregnancy rate, continued pregnancy rate and abortion rate after IVF-ET.