宫腔内人工授精使用米索前列醇疗效与安全性的系统评价_《中国循证医学杂志》

作者：

宋荣 ¹ ,  蔡霞 ¹ , 吴泰相 ²

1. 新疆医科大学第一附属医院生殖助孕中心（乌鲁木齐 830054 ）； 2. 四川大学华西医院中国循证医学中心（成都 610041）;

关键词：

宫腔内人工授精米索前列醇系统评价

DOI：

10.7507/1672-2531.20100547

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　评价宫腔内人工授精（IUI）时使用米索前列醇的疗效和安全性。
方法　计算机检索Cochrane 图书馆（2009年第3期）、EMbase、MEDLINE、ScienceDirect、中国生物医学文献数据库、万方数字化期刊全文数据库、中国期刊全文数据库，收集IUI后使用米索前列醇与对照组比较的临床随机对照试验（RCT）。检索时限为建库至2009年10月。按纳入与排除标准选择研究，评价纳入RCT质量和提取资料，而后采用RevMan 5.0软件进行Meta分析。
结果　共纳入5个RCT，合计546例患者、1 133个IUI周期。其中2个研究证据等级高，3个研究证据等级为中。Meta分析结果显示，400 μg米索前列醇与安慰剂组相比，可提高IUI的妊娠率［RR= 1.95，95%CI（1.19，3.19）］。400 μg米索前列醇组比200 μg米索前列醇组腹痛［RR=3.13，95%CI（1.86，5.26）］及阴道流血［RR= 5.25，95%CI（2.08，13.21）］的发生率高。
结论　目前米索前列醇对IUI疗效及安全性的临床试验太少， IUI时使用米索前列醇的疗效与安全性尚难定论，还需要更多高质量、大样本的随机对照试验进一步验证。

引用本文： 宋荣,蔡霞,吴泰相. 宫腔内人工授精使用米索前列醇疗效与安全性的系统评价. 中国循证医学杂志, 2010, 10(9): 1072-1078. doi: 10.7507/1672-2531.20100547 复制

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, 高尔生. 中国育龄妇女不孕率及其影响因素分析. 中国卫生统, 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, 王文军, 张清学, 等. 1136周期宫腔内夫精人工授精临床因素的分析. 中国妇幼保健, 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.	吴泰相, 刘关键. 隐蔽分组（分配隐藏）和盲法的概念, 实施与报告. 中国循证医学杂志, 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, 高尔生. 中国育龄妇女不孕率及其影响因素分析. 中国卫生统, 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, 王文军, 张清学, 等. 1136周期宫腔内夫精人工授精临床因素的分析. 中国妇幼保健, 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. 吴泰相, 刘关键. 隐蔽分组（分配隐藏）和盲法的概念, 实施与报告. 中国循证医学杂志, 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.

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宫腔内人工授精使用米索前列醇疗效与安全性的系统评价

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《中国循证医学杂志》

宫腔内人工授精使用米索前列醇疗效与安全性的系统评价

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