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目的:系统评价选择性5-羟色胺再摄取抑制剂(SSRI)用于行体外受精联合胚胎移植术的抑郁症妇女的妊娠安全性,为临床提供循证参考。方法:计算机检索PubMed、EMBase、Cochrane图书馆、Medline、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据库,纳入SSRI(试验组)对比不接受药物或仅使用安慰剂(对照组)用于行体外受精联合胚胎移植术的抑郁症妇女的试验,提取资料并评价质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入4项研究,合计2 122例患者。Meta分析结果显示,两组患者流产率[RR=0.90,95%CI(0.61,1.35),P=0.62]、受孕率[RR=1.03,95%CI(0.73,1.45),P=0.87]和胎儿出生率[RR=1.03,95%CI(0.65,1.63),P=0.91]比较,差异均无统计学意义。结论:SSRI用于行体外受精联合胚胎移植术的抑郁症妇女不会增加流产率,对受孕率和胎儿出生率亦无显著影响。
OBJECTIVE: To systematically evaluate the safety of selective serotonin reuptake inhibitors (SSRIs) for depression in women undergoing IVF in combination with embryo transfer and provide evidence-based reference for clinical practice. METHODS: PubMed, EMBase, Cochrane Library, Medline, China Biomedical Literature Database, Chinese Journal Full-text Database, Chinese Science and Technology Periodical Database and Wanfang Database were searched by computer. SSRI (trial group) was compared with no drug or placebo alone Control group) were used in women with depression who underwent in vitro fertilization combined with embryo transfer. Data were extracted and evaluated for quality. Meta-analysis was performed using RevMan 5.3 statistical software. Results: A total of 4 studies were included, totaling 2,122 patients. Meta-analysis showed that miscarriage rate [RR = 0.90,95% CI (0.61,1.35), P = 0.62], pregnancy rate [RR = 1.03,95% CI (0.73,1.45), P = 0.87] and Fetal birth rate [RR = 1.03, 95% CI (0.65,1.63), P = 0.91], the difference was not statistically significant. Conclusions: Women with depression using SSRI for IVF combined with embryo transfer will not increase abortion rates, nor do they have any significant effect on the rate of conception and birth rate.