宮腔內人工授精使用米索前列醇療效與安全性的系統評價_《中國循證醫學雜志》

作者：

宋榮 ¹ ,  蔡霞 ¹ , 吳泰相 ²

1. 新疆醫科大學第一附屬醫院生殖助孕中心（烏魯木齊 830054 ）； 2. 四川大學華西醫院中國循證醫學中心（成都 610041）;

關鍵詞：

宮腔內人工授精米索前列醇系統評價

DOI：

10.7507/1672-2531.20100547

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　評價宮腔內人工授精（IUI）時使用米索前列醇的療效和安全性。
方法　計算機檢索Cochrane 圖書館（2009年第3期）、EMbase、MEDLINE、ScienceDirect、中國生物醫學文獻數據庫、萬方數字化期刊全文數據庫、中國期刊全文數據庫，收集IUI后使用米索前列醇與對照組比較的臨床隨機對照試驗（RCT）。檢索時限為建庫至2009年10月。按納入與排除標準選擇研究，評價納入RCT質量和提取資料，而后采用RevMan 5.0軟件進行Meta分析。
結果　共納入5個RCT，合計546例患者、1 133個IUI周期。其中2個研究證據等級高，3個研究證據等級為中。Meta分析結果顯示，400 μg米索前列醇與安慰劑組相比，可提高IUI的妊娠率［RR= 1.95，95%CI（1.19，3.19）］。400 μg米索前列醇組比200 μg米索前列醇組腹痛［RR=3.13，95%CI（1.86，5.26）］及陰道流血［RR= 5.25，95%CI（2.08，13.21）］的發生率高。
結論　目前米索前列醇對IUI療效及安全性的臨床試驗太少， IUI時使用米索前列醇的療效與安全性尚難定論，還需要更多高質量、大樣本的隨機對照試驗進一步驗證。

引用本文： 宋榮,蔡霞,吳泰相. 宮腔內人工授精使用米索前列醇療效與安全性的系統評價. 中國循證醫學雜志, 2010, 10(9): 1072-1078. doi: 10.7507/1672-2531.20100547 復制

1.	Shea OR, Shah IH. Chapter 08 Conclusion //Sidney Moore. Infecundity, Infertility, and Childlessness in Developing Countries. DHS Comparative Reports No. 9. Calverton, Maryland, USA: ORC Macro and the World Health Organization, 2004: 53-54.
2.	Safarinejad MR. Infertility among couples in a population-based study in Iran: prevalence and associated risk factors. Int J Androl, 2008, 31(3): 303-314.
3.	Larsen U. Research on infertility: which definition should we use. Fertil Steril, 2005, 83(4): 846-852.
4.	Boivin J, Bunting L, Collins JA, et al. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod, 2007, 22(6): 1506-1512.
5.	高峻, 高爾生. 中國育齡婦女不孕率及其影響因素分析. 中國衛生統, 2005, 22(2): 26-28.
6.	Moslemizadeh N, Moghadam TG, Peyvandi S. Evaluation of vaginal misoprostol effect on pregnancy rate after intrauterine insemination. Pak J Biol Sci, 2009, 12(1): 64-68.
7.	Billiet K, Dhont M, Vervaet C, et al. A multi-center prospective, randomized, double-blind trial studying the effect of misoprostol on the outcome of intrauterine insemination. Gynecol Obstet Invest, 2008, 66: 145-151.
8.	侯翠, 王文軍, 張清學, 等. 1136周期宮腔內夫精人工授精臨床因素的分析. 中國婦幼保健, 2009, 24(11): 1521-1523.
9.	Janssen MJ, Cohlen BJ, Cantineau AEP. Timing modalities for intrauterine insemination in subfertile couples(Protocol). Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD006942. DOI: 10.1002/14651858.CD006942.
10.	Agarwal S, MittalIndian S. A randomised prospective trial of intrauterine insemination versus timed intercourse in superovulated cycles with clomiphene. Indian J Med Res, 2004, 120: 519-522.
11.	Ensieh Sh, Nejad T, Abediasl Z, et al. Comparison of the efficacy of the aromatase inhibitor letrozole and clomiphen citrate gonadotropins in controlled ovarian hyperstimulation: a prospective, simply randomized, clinical trial. J Assist Reprod Genet, 2008, 25: 187-190.
12.	Erdem A, Erdem M, Atmaca S, et al. Factors affecting live birth rate in intrauterine insemination cycles with recombinant gonadotrophin stimulation. Reprod Biomed Online, 2008, 7(2): 99-206.
13.	van Rumste MME, Custers IM, van der Veen F, et al. The influence of the number of follicles on pregnancy rates in intrauterine insemination with ovarian stimulation: a meta-analysis. Hum Reprod Update, 2008, 14(6): pp 563-570.
14.	Snick HK, Collins JA, Evers JLH, et al. What is the most valid comparison treatment in trials of intrauterine insemination, timed or uninfluenced intercourse? A systematic review and meta-analysis of indirect evidence. Hum Reprod, 2008, 23(10): 2239-2245.
15.	The ESHRE Capri Workshop Group. Intrauterine insemination. Hum Reprod Update, 2009, 15(3): 265-277.
16.	Cantineau AEP, Heineman MJ, Cohlen BJ. Single versus double intrauterine insemination in stimulated cycles for subfertile couples: a systematic review based on a Cochrane review. Hum Reprod, 2003, 18(5): 941-946.
17.	Abou-Setta AM, Mansour RT, Al-Inany HG. Intrauterine insemination catheters for assisted reproduction: a systematic review and meta-analysis. Hum Reprod, 2006, 21(8): 1961-1967.
18.	Brown SE, Toner JP, Schnorr JA, et al. Vaginal misoprostol enhances intrauterine insemination. Hum Reprod, 2001, 16(1): 96-101.
19.	Barroso G, Karchmer S, Castelazo E, et al. A prospective randomized trial of the impact of misoprostol (PgE1) on pregnancy rate after intrauterine insemination (IUI) therapy: a preliminary report. Ginecol Obstet Mex, 2001, 69: 346-350.
20.	Toner J, de Ziegler D, Brown S, et al. High rates of cramping with misoprostol administration for intrauterine insemination. Hum Reprod, 2001, 16(5): 1051-1052.
21.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.1 .
22.	吳泰相, 劉關鍵. 隱蔽分組（分配隱藏）和盲法的概念, 實施與報告. 中國循證醫學雜志, 2007, 7(3): 222-224.
23.	Cantineau AE, Cohlen BJ, Dutch IUI Study Group. The prevalence and influence of luteinizing hormone surges in stimulated cycles combined with intrauterine insemination during a prospective cohort study. Fertil Steril, 2007, 88: 107-112.

1. Shea OR, Shah IH. Chapter 08 Conclusion //Sidney Moore. Infecundity, Infertility, and Childlessness in Developing Countries. DHS Comparative Reports No. 9. Calverton, Maryland, USA: ORC Macro and the World Health Organization, 2004: 53-54.
2. Safarinejad MR. Infertility among couples in a population-based study in Iran: prevalence and associated risk factors. Int J Androl, 2008, 31(3): 303-314.
3. Larsen U. Research on infertility: which definition should we use. Fertil Steril, 2005, 83(4): 846-852.
4. Boivin J, Bunting L, Collins JA, et al. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod, 2007, 22(6): 1506-1512.
5. 高峻, 高爾生. 中國育齡婦女不孕率及其影響因素分析. 中國衛生統, 2005, 22(2): 26-28.
6. Moslemizadeh N, Moghadam TG, Peyvandi S. Evaluation of vaginal misoprostol effect on pregnancy rate after intrauterine insemination. Pak J Biol Sci, 2009, 12(1): 64-68.
7. Billiet K, Dhont M, Vervaet C, et al. A multi-center prospective, randomized, double-blind trial studying the effect of misoprostol on the outcome of intrauterine insemination. Gynecol Obstet Invest, 2008, 66: 145-151.
8. 侯翠, 王文軍, 張清學, 等. 1136周期宮腔內夫精人工授精臨床因素的分析. 中國婦幼保健, 2009, 24(11): 1521-1523.
9. Janssen MJ, Cohlen BJ, Cantineau AEP. Timing modalities for intrauterine insemination in subfertile couples(Protocol). Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD006942. DOI: 10.1002/14651858.CD006942.
10. Agarwal S, MittalIndian S. A randomised prospective trial of intrauterine insemination versus timed intercourse in superovulated cycles with clomiphene. Indian J Med Res, 2004, 120: 519-522.
11. Ensieh Sh, Nejad T, Abediasl Z, et al. Comparison of the efficacy of the aromatase inhibitor letrozole and clomiphen citrate gonadotropins in controlled ovarian hyperstimulation: a prospective, simply randomized, clinical trial. J Assist Reprod Genet, 2008, 25: 187-190.
12. Erdem A, Erdem M, Atmaca S, et al. Factors affecting live birth rate in intrauterine insemination cycles with recombinant gonadotrophin stimulation. Reprod Biomed Online, 2008, 7(2): 99-206.
13. van Rumste MME, Custers IM, van der Veen F, et al. The influence of the number of follicles on pregnancy rates in intrauterine insemination with ovarian stimulation: a meta-analysis. Hum Reprod Update, 2008, 14(6): pp 563-570.
14. Snick HK, Collins JA, Evers JLH, et al. What is the most valid comparison treatment in trials of intrauterine insemination, timed or uninfluenced intercourse? A systematic review and meta-analysis of indirect evidence. Hum Reprod, 2008, 23(10): 2239-2245.
15. The ESHRE Capri Workshop Group. Intrauterine insemination. Hum Reprod Update, 2009, 15(3): 265-277.
16. Cantineau AEP, Heineman MJ, Cohlen BJ. Single versus double intrauterine insemination in stimulated cycles for subfertile couples: a systematic review based on a Cochrane review. Hum Reprod, 2003, 18(5): 941-946.
17. Abou-Setta AM, Mansour RT, Al-Inany HG. Intrauterine insemination catheters for assisted reproduction: a systematic review and meta-analysis. Hum Reprod, 2006, 21(8): 1961-1967.
18. Brown SE, Toner JP, Schnorr JA, et al. Vaginal misoprostol enhances intrauterine insemination. Hum Reprod, 2001, 16(1): 96-101.
19. Barroso G, Karchmer S, Castelazo E, et al. A prospective randomized trial of the impact of misoprostol (PgE1) on pregnancy rate after intrauterine insemination (IUI) therapy: a preliminary report. Ginecol Obstet Mex, 2001, 69: 346-350.
20. Toner J, de Ziegler D, Brown S, et al. High rates of cramping with misoprostol administration for intrauterine insemination. Hum Reprod, 2001, 16(5): 1051-1052.
21. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.1 .
22. 吳泰相, 劉關鍵. 隱蔽分組（分配隱藏）和盲法的概念, 實施與報告. 中國循證醫學雜志, 2007, 7(3): 222-224.
23. Cantineau AE, Cohlen BJ, Dutch IUI Study Group. The prevalence and influence of luteinizing hormone surges in stimulated cycles combined with intrauterine insemination during a prospective cohort study. Fertil Steril, 2007, 88: 107-112.

上一篇
中國兒童尿道損傷外科處理的系統評價
下一篇
馬來酸桂哌齊特治療急性腦梗塞的系統評價

《中國循證醫學雜志》

宮腔內人工授精使用米索前列醇療效與安全性的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

宮腔內人工授精使用米索前列醇療效與安全性的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料