ObjectivesTo systematically review the efficacy of adjuvant growth hormone (GH) in IVF protocols.MethodsCBM, WanFang Data, CNKI, VIP, PubMed, EMbase, Web of Science and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of adjuvant GH in IVF protocols from inception to October 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, the meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 10 RCTs involving 691 infertile females were included. Results of meta-analysis demonstrated that adjuvant GH in IVF protocols could increase collected oocytes number (MD=1.58, 95%CI 1.29 to 1.87, P<0.000 01), MⅡ stage oocytes number (MD=2.26, 95%CI 1.77 to 2.74, P<0.000 01), implantation rate (RR=1.20, 95%CI 1.02 to 1.40, P=0.03), clinical pregnancy rate (RR=1.46, 95%CI 1.08 to 1.98, P=0.01) and live birth rate (RR=1.62, 95%CI 1.05 to 2.51, P=0.03). However, there was no difference in fertilization rate (RR=1.06, 95%CI 0.97 to 1.16, P<0.18), miscarriage rate (RR=1.44, 95%CI 0.65 to 3.17, P=0.37) and adverse reactions between two groups.ConclusionsCurrent evidence shows that GH can improve the fertility outcomes of IVF cycles in patients with POR, elderly or previous IVF failures. But due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
ObjectiveTo systematically evaluate the efficacy and safety of different low-molecular-weight heparins (LMWHs) in improving pregnancy outcomes in patients with recurrent abortion. MethodsThe PubMed, EMbase, Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to July 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 25 RCTs involving 4 631 patients were included. Enoxaparin, dalteparin, nadroparin, and tinzaparin were included. The results of network meta-analysis showed that the live birth rate of the tinzaparin was higher than that of enoxaparin and dalteparin. The live birth rate in nadroparin was higher than that in enoxaparin and dalteparin. The cumulative sorting probability showed that tinzaparin ranked best for improving the live birth rate, nadroparin ranked best for reducing the miscarriage rate, and enoxaparin ranked best for reducing the preterm birth rate. ConclusionCurrent evidence suggests that tinzaparin and nadroparin may be the best choice for improving pregnancy outcomes in patients with recurrent abortion. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To analyze the efficacy and safety of different acupuncture methods on outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods The PubMed, EMbase, Cochrane Library, CNKI, VIP, WanFang Data and CBM databases were searched to collect randomized controlled trials (RCTs) related to the objectives of the study from the inception to April 16, 2023. After two investigators independently screened the literature, extracted the data and evaluated the risk of bias of the included studies, a network meta-analysis was performed using Stata 16.0 software. Results There were 62 trials total with 9844 patients, involving 7 interventions. Network meta-findings analysis revealed the following: ① Clinical pregnancy rate (CPR): needle warming > auricular acupressure > transcutaneous electrical acupoint stimulation (TEAS) > electroacupuncture > acupuncture > sham acupuncture > no adjunctive treatment; ② Live birth rate (LBR): electroacupuncture > auricular acupressure > TEAS > acupuncture > sham acupuncture > no adjunctive treatment. Conclusion Needle warming assisted IVF-ET is superior to other acupuncture therapies in improving CPR, especially during the promotion period of excretion, and the selection of Zusanli, Guanyuan and uterine acupoints for 3-month cycles may have the best effect. And for the LBR, the effect of electroacupuncture is better than that of other therapies. Besides, auricular acupressure may have good therapeutic potential. Due to the limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.