Is glucocorticoid use associated with a higher clinical pregnancy rate of in vitro fertilization and embryo transfer? A meta-analysis
Background: It has been reported that the use of glucocorticoids may be able to improve clinical pregnancy rates in patients receiving in vitro fertilization and embryo transfer (IVF-ET). The purpose of this study was to investigate the association between glucocorticoid use and clinical pregnancy r...
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Elsevier
2023-05-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023030402 |
| _version_ | 1797815637694742528 |
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| author | Yaxuan Lv Yue Chen Lei Hu Haitian Ding Mengqing Liu Hailong Li Yuyang Hou Qiong Xing |
| author_facet | Yaxuan Lv Yue Chen Lei Hu Haitian Ding Mengqing Liu Hailong Li Yuyang Hou Qiong Xing |
| author_sort | Yaxuan Lv |
| collection | DOAJ |
| description | Background: It has been reported that the use of glucocorticoids may be able to improve clinical pregnancy rates in patients receiving in vitro fertilization and embryo transfer (IVF-ET). The purpose of this study was to investigate the association between glucocorticoid use and clinical pregnancy rate in IVF-ET patients. Methods: This study has been registered on the International Register of Prospective Systems Evaluation (PROSPERO) (ID: CRD42022375427). A thorough and detailed search of databases including PubMed, Web of Science, Embase, and Cochrane Library was conducted to identify eligible studies up to October 2022. Quality assessment was conducted on the modified Jadad Scoring Scale and Newcastle-Ottawa Scale, and the inter-study heterogeneity was estimated by Q test and I2 test. Combined hazard ratios with 95% CI were calculated using random effects or fixed effects models based on heterogeneity. Meanwhile, Begg's and Egger's tests were used to detect the existence of publication bias, the leave-one-out method was used for sensitivity analysis and multiple subgroup analyses were conducted. Results: Seventeen studies involving 3056 IVF-ET cycles were included. We found that glucocorticoid use was associated with a higher IVF-ET pregnancy rate (OR = 1.86, 95% CI = 1.27–2.74, P = 0.002). In the subgroup analysis, studies of different regions and different study types all showed similar results that glucocorticoid is beneficial to improve the clinical pregnancy rate of patients with IVF-ET, and patients with positive autoantibodies and patients receiving IVF-ET multiple times also showed the same results. However, there was no significant change in clinical pregnancy rates in the seven studies with negative autoantibodies and in the seven studies with initial IVF-ET treatment. The results of the 12 medium-acting glucocorticoids and 4 long-acting glucocorticoids were also generally consistent with each other. There was no statistical difference in subgroup analysis of whether patients had endometriosis or not. Conclusion: Appropriate use of glucocorticoids is beneficial for improving the clinical pregnancy rate in women receiving IVF-ET, but this result still needs to be verified by more high-quality and large sample size randomized controlled trials (RCTs). |
| first_indexed | 2024-03-13T08:25:48Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-13T08:25:48Z |
| publishDate | 2023-05-01 |
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| series | Heliyon |
| spelling | doaj.art-77620a8f2d4b4328965785c2bfc9eb472023-05-31T04:45:42ZengElsevierHeliyon2405-84402023-05-0195e15833Is glucocorticoid use associated with a higher clinical pregnancy rate of in vitro fertilization and embryo transfer? A meta-analysisYaxuan Lv0Yue Chen1Lei Hu2Haitian Ding3Mengqing Liu4Hailong Li5Yuyang Hou6Qiong Xing7Department of Clinical Medicine, School of the First Clinical Medicine, Anhui Medical University, Hefei, ChinaDepartment of Clinical Medicine, School of the First Clinical Medicine, Anhui Medical University, Hefei, ChinaDepartment of Clinical Medicine, School of the First Clinical Medicine, Anhui Medical University, Hefei, China; Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Clinical Medicine, School of the First Clinical Medicine, Anhui Medical University, Hefei, ChinaDepartment of Clinical Medicine, School of the Chaohu Clinical Medicine, Anhui Medical University, Hefei, ChinaSun Yat-sen University, No.74 Nonglin Road, Guangzhou, 510030, Guangdong, ChinaDepartment of Clinical Medicine, School of the First Clinical Medicine, Anhui Medical University, Hefei, ChinaReproductive Medicine Center, Department of Obstetrics and Gynecology, First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei, 230022, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, Hefei, 230032, Anhui, China; Corresponding author. Reproductive Medicine Center, Department of Obstetrics and Gynecology, First Affiliated Hospital of Anhui Medical University, No 218 Jixi Road, Hefei230022, Anhui, ChinaBackground: It has been reported that the use of glucocorticoids may be able to improve clinical pregnancy rates in patients receiving in vitro fertilization and embryo transfer (IVF-ET). The purpose of this study was to investigate the association between glucocorticoid use and clinical pregnancy rate in IVF-ET patients. Methods: This study has been registered on the International Register of Prospective Systems Evaluation (PROSPERO) (ID: CRD42022375427). A thorough and detailed search of databases including PubMed, Web of Science, Embase, and Cochrane Library was conducted to identify eligible studies up to October 2022. Quality assessment was conducted on the modified Jadad Scoring Scale and Newcastle-Ottawa Scale, and the inter-study heterogeneity was estimated by Q test and I2 test. Combined hazard ratios with 95% CI were calculated using random effects or fixed effects models based on heterogeneity. Meanwhile, Begg's and Egger's tests were used to detect the existence of publication bias, the leave-one-out method was used for sensitivity analysis and multiple subgroup analyses were conducted. Results: Seventeen studies involving 3056 IVF-ET cycles were included. We found that glucocorticoid use was associated with a higher IVF-ET pregnancy rate (OR = 1.86, 95% CI = 1.27–2.74, P = 0.002). In the subgroup analysis, studies of different regions and different study types all showed similar results that glucocorticoid is beneficial to improve the clinical pregnancy rate of patients with IVF-ET, and patients with positive autoantibodies and patients receiving IVF-ET multiple times also showed the same results. However, there was no significant change in clinical pregnancy rates in the seven studies with negative autoantibodies and in the seven studies with initial IVF-ET treatment. The results of the 12 medium-acting glucocorticoids and 4 long-acting glucocorticoids were also generally consistent with each other. There was no statistical difference in subgroup analysis of whether patients had endometriosis or not. Conclusion: Appropriate use of glucocorticoids is beneficial for improving the clinical pregnancy rate in women receiving IVF-ET, but this result still needs to be verified by more high-quality and large sample size randomized controlled trials (RCTs).http://www.sciencedirect.com/science/article/pii/S2405844023030402IVF-ETMeta-analysisGlucocorticoidClinical pregnancy rateSystematic review |
| spellingShingle | Yaxuan Lv Yue Chen Lei Hu Haitian Ding Mengqing Liu Hailong Li Yuyang Hou Qiong Xing Is glucocorticoid use associated with a higher clinical pregnancy rate of in vitro fertilization and embryo transfer? A meta-analysis Heliyon IVF-ET Meta-analysis Glucocorticoid Clinical pregnancy rate Systematic review |
| title | Is glucocorticoid use associated with a higher clinical pregnancy rate of in vitro fertilization and embryo transfer? A meta-analysis |
| title_full | Is glucocorticoid use associated with a higher clinical pregnancy rate of in vitro fertilization and embryo transfer? A meta-analysis |
| title_fullStr | Is glucocorticoid use associated with a higher clinical pregnancy rate of in vitro fertilization and embryo transfer? A meta-analysis |
| title_full_unstemmed | Is glucocorticoid use associated with a higher clinical pregnancy rate of in vitro fertilization and embryo transfer? A meta-analysis |
| title_short | Is glucocorticoid use associated with a higher clinical pregnancy rate of in vitro fertilization and embryo transfer? A meta-analysis |
| title_sort | is glucocorticoid use associated with a higher clinical pregnancy rate of in vitro fertilization and embryo transfer a meta analysis |
| topic | IVF-ET Meta-analysis Glucocorticoid Clinical pregnancy rate Systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023030402 |
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