Effectiveness of in Vitro Fertilization Embryo Transfer Conducted With Two Kinds of Down Regulation Protocols on Infertile Patients With Endometriosis: A Meta Analysis

Abstract

Objective To evaluate the effectiveness of two kinds of down regulation protocols used in vitro fertilization embryo transfer( IVF-ET) in infertile patients with endometriosis(EMs). Methods CBM disc, Wan fang, CNKI, VIP, Pubmed, PML, FMJS were searched for randomized controlled trails(RCTs) on the comparison between prolonged protocol and long protocol in IVF-ET in infertility patients with EMs. The bibliography of the included studies were searched, too. The duration of search was form January 2000 to June 2012.The quality of the included was evaluated by three evaluators. For the homogeneous studies we performed Meta analysis. The extracted data were analyzed by RenMan 5.1. Results Seven literatures with 593 participants were selected for Meta analysis based on our including standards. Which involving 219 cases with prolonged protocol and 374 cases with long protocol of gonadotrophins(Gn). Meta analyses showed that prolonged protocol compared with long protocol cancellation rates were no significant difference in two groups at WMD=0.69 and 95%CI: 0.32-1.51; gonadotrophin releasing hormone analogue(GnRHa) stimulation durations were no significant difference in two groups at WMD=0.12 and 95% CI: -0.04-0.28; doses of GnRHa in prolonged protocol group were higher at the WMD=-311.25 and 95%CI: 6.43-616.08, the differences were statistically significant; the number of oocytes retrieved was no significant difference between two group at the WMD=-0.65 and 95%CI: -1.76-0.47(P>0.05); the differences were statistically significant serum E2 levels on the day of human chorionic gonadotrophin(hCG) administration was no significant difference in two groups at the WMD=-499.71 and 95%CI: -1171.02-171.60(P>0.05); clinical pregnancy rates in prolonged protocol group were slightly higher at the WMD=2.23 and 95%CI: 1.49-3.33, the differences were statistically significant(P 0.05). Conclusions In EMs patients with infertility IVF-ET treatment, compared with long protocol, the prolonged protocol can obviously increase the clinical pregnancy rate, so the IVF-ET may be an ideal choice for EMs patients with infertility. Because the including trails exist insufficiency on quality and quantity as well as the methodology difference, suggested that this research conclusion only serve as the reference of the clinical analysis, need reevaluation and renew unceasingly. Key words: endometriosis; in vitro fertilization embryo transfer; prolonged/ultralong protocol; long protocol; Mate analysis