The efficacy of adjuvant therapies in improving endometrial function of women undergoing assisted reproductive technology: a systematic review and network meta-analysis
Abstract
Objective: Assessment of the endometrium is an essential component in assisted reproduction. While various adjuvant therapies have been used to improve endometrial function, these results are controversial.
Methods: This meta-analysis aimed to compare the effectiveness of various adjuvant treatment strategies in improving the endometrial thickness and clinical outcome of women undergoing assisted reproduction technology (ART). The PubMed, Embase, and Cochrane Library databases were systematically searched for articles published from database inception to 30 December 2022, without language restrictions.
Results: Sixteen RCTs involving 1325 patients and 4 prospective trials involving 379 patients were ultimately included in our study. Compared with controls, Sildenafil (WMD: 1.66, CI 0.59-2.74), PRP (1.34, 0.54-2.15), and G-CSF (1.27, 0.62-1.93) were significantly improved endometrial thickness. With regard to the Biochemical pregnancy rate, only PRP (4.28, 1.26-14.56) were associated with a significantly increased of BPR, compared with controls. With regard to clinical pregnancy rate, Aspirin, G-CSF, GH and PRP showed a better CPR than control (1.87, 1.06-3.29; 2.03, 1.23-3.34; 1.73, 1.02-2.94; 2.66, 1.27-5.57, respectively). None of the included adjuvant treatments were significantly different from control or from each other on miscarriage rate, implantation rate and live birth rate. The findings from subgroup analysis we planned study population did not differ significantly…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,325 participants or records.
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