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Objective <p>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.</p> Methods <p>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.</p> Results <p>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 from those of the primary analyses for most comparisons.</p> Conclusions <p>For women undergoing assisted reproductive technology, using adjuvant treatment with Sildenafil, PRP and G-CSF showed better endometrial thickness and clinical outcomes, and in women with thin endometrium, the results were similar to the primary analyses.</p>

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The efficacy of adjuvant therapies in improving endometrial function of women undergoing assisted reproductive technology: a systematic review and network meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月12日

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  • Xin Li,
  • Jueyun Lu,
  • JuanJuan Zhang,
  • Ting Luan,
  • Chun Zhao,
  • Xiufeng Ling

摘要

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 from those of the primary analyses for most comparisons.

Conclusions

For women undergoing assisted reproductive technology, using adjuvant treatment with Sildenafil, PRP and G-CSF showed better endometrial thickness and clinical outcomes, and in women with thin endometrium, the results were similar to the primary analyses.