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目的:探究激光辅助孵化(LAH)对行胚胎移植不孕患者妊娠结局的影响。方法:计算机检索Pub Med、Ovid SP、Medline、Cochrane Library、CNKI、CBM、万方和维普等数据库,纳入LAH与其他多种辅助孵化方法和不作任何处理组比较的随机对照试验(RCT),检索年限截至2015年10月,语言不限,按照Cochrane协作组建议对纳入文献行质量评价和异质性分析,数据分析采用Rev Man 5.3.5软件。结果:纳入25个RCT;激光组分别与酸化组、机械组和对照组(不作任何处理)进行比较,继续妊娠率、流产率、活产率等差异均无统计学意义(P>0.05);对选择行冻融胚胎移植(FET)的患者,激光组较对照组有较高的种植率及临床妊娠率,差异有统计学意义(P<0.000 01;P<0.05);但多胎率显著增加(P<0.05)。结论:对选择行FET的患者,LAH较不做任何处理更有优势,可以提高种植率和临床妊娠率,值得推广及应用,但LAH会增加多胎发生的风险。
Objective: To investigate the effect of laser-assisted hatching (LAH) on pregnancy outcomes in infertile patients undergoing embryo transfer. METHODS: The databases of Pub Med, Ovid SP, Medline, Cochrane Library, CNKI, CBM, Wanfang and Vipu were searched by computer. A randomized controlled trial (RCT) comparing LAH with other assisted hatching methods and no treatment group was included. Years As of October 2015, the language is not limited. According to the Cochrane Collaboration, the quality assessment and heterogeneity analysis of the included literature were used. The data analysis used Rev Man 5.3.5 software. Results: The 25 RCTs were included. There was no significant difference in the pregnancy rate, miscarriage rate and live birth rate among the laser group, the acid group, the mechanical group and the control group (without any treatment), respectively. For patients who underwent frozen-thawed embryo transfer (FET), the laser group had higher implantation rate and clinical pregnancy rate than the control group (P <0.000 01; P <0.05), but the multiple birth rate was significantly increased (P <0.05). CONCLUSIONS: LAH is more advantageous than non-FET treatment in patients with FET. It can improve the implantation rate and clinical pregnancy rate, which is worthy of popularization and application. However, LAH increases the risk of multiple births.