Abstract
Purpose
We aimed to evaluate the effect of luteal phase support (LPS) on pregnancy outcome in natural cycle frozen embryo transfer (NC-FET).
Method
We searched PubMed, Cochrane Library, Embase for related literature from start to February 2020. Relative risk ratio (RR) and 95% confidence intervals (95% CI) in random-effects, fixed-effects models were calculated using Review Manager 5.3.
Results
Totally 9 studies were included in the meta-analysis. The results showed no significant difference could be found regarding chemical pregnancy rate (RR 1.07, 95% CI 0.93–1.22; I2 = 54%) and miscarriage rate (RR 0.92, 95% CI 0.70–1.22; I2 = 0%) between the LPS groups and no LPS groups in NC-FET. LPS groups has increased the rate of clinical pregnancy rate (RR 1.23, 95% CI 1.12–1.34; I2 = 52%) compared with no LPS groups. Subgroup analysis according to trigger administration also showed a significant difference between the two groups.
Conclusion
LPS might improve the clinical pregnancy rate in NC-FET. HCG trigger for ovulating may result in luteal phase deficiency. LPS subsequently improved clinical pregnancy rate and chemical pregnancy rate for patients undergoing HCG trigger and NC-FET.
Retrospectively registered
This meta-analysis was registered at PROSPERO, PROSPERO ID is CRD42020171758.
自然周期冷冻胚胎移植的黄体期支持:荟萃分析 摘要
目的:我们旨在评估黄体期支持(LPS)对自然周期冷冻胚胎移植(NC-FET)妊娠结局的影响。
方法:我们从 2020 年 2 月开始在 PubMed、Cochrane 图书馆、Embase 中搜索相关文献。使用 Review Manager 5.3 计算随机效应、固定效应模型中的相对风险比 (RR) 和 95% 置信区间 (95% CI) 。
结果:荟萃分析共纳入 9 项研究。结果显示, 自然周期冷冻胚胎移植的LPS组和无LPS组之间的生化妊娠率(RR 1.07, 95% CI 0.93–1.22; I2=54%)和流产率(RR 0.92, 95% CI 0.70–1.22; I2=0%)无显著差异。与无 LPS 组相比, LPS 组增加了临床妊娠率 (RR 1.23, 95% CI 1.12–1.34; I2=52%)。根据是否给药的亚组分析也显示两组之间存在显著差异。
结论:黄体期支持可提高自然周期冷冻胚胎移植临床妊娠率。促排卵的 HCG 扳机可能导致黄体期不足。对NC-FET 的患者进行黄体期支持提高了HCG 扳机后临床妊娠率和化学妊娠率。
回顾性注册:该荟萃分析已在 PROSPERO 注册, PROSPERO ID 为CRD42020171758。
Disclosure statement
No potential conflict of interest was reported by the authors.