Large randomized trial comparing transabdominal ultrasoundguided embryo transfer

Large randomized trial comparing transabdominal ultrasound-guided embryo transfer with a technique based on uterine length measurement before embryo transfer Revelli et al. , UOG 2016 目的在大量接受体外受精的患者中，用TA-UGET在移植前�量子� �度（ULMb. ET），从而比��种胚胎移植技�

Large randomized trial comparing transabdominal ultrasound-guided embryo transfer with a technique based on uterine length measurement before embryo transfer Revelli et al. , UOG 2016 方法 �入�准 • 43�以下患者，缺乏子�不孕原因，之前��接受 1 -3 个新�胚胎卵裂期移植首要�局 • 每个胚胎移植的�床妊娠率 • 在胚胎移植10周后的持�妊娠 • 移植率数据分析 • 意向�理分析

Large randomized trial comparing transabdominal ultrasound-guided embryo transfer with a technique based on uterine length measurement before embryo transfer Revelli et al. , UOG 2016 �入�价（n=1884）排除原因（n=146）: 拒�参与（n=58）希望囊胚期胚胎移植(n=50) 周期取消，无胚胎移植（ n=38）随机胚胎移植（n=1738）分配� TAUGET（ n=866）分析（ n=820）因�管�化� 致胚胎移植困 �被排除的（ n=46）分配� UL Mb. ET( n=872) 分析（ n=828）因�管�化�致胚胎移植困�被排除的（n=44）

Large randomized trial comparing transabdominal ultrasound-guided embryo transfer with a technique based on uterine length measurement before embryo transfer Revelli et al. , UOG 2016 �果：首要�局（治�分析）参数 �床妊娠率 /ET 移植率持�妊娠率 /ET ULMb. ET (n=828) TA-UGET (n=820) P 38. 2% 38. 9% 0. 83 24. 8% 25. 2% 0. 78 33. 1% 34. 8% 0. 47 意向�理分析，包括在ET期�要求��管的那些病人，确定了没有�著差异。

Large randomized trial comparing transabdominal ultrasound-guided embryo transfer with a technique based on uterine length measurement before embryo transfer Revelli et al. , UOG 2016 �果：第二个�局 • • • 当将ULMb. ET和TA-UGET两者�行比��，在流�率、双胎率或者操作��无� 著差异当使用TA-UGET�，�察到明�的不适 2. 6 比 1. 5 VAS 点; P=0. 045 在TA-UGET�中度到重度不适的病人比例�著增高。 19. 8% 比 1. 2%; P=0. 003

Large randomized trial comparing transabdominal ultrasound-guided embryo transfer with a technique based on uterine length measurement before embryo transfer Revelli et al. , UOG 2016 �� • �种非劣性RCT的�果�示，ULMb. ET�致IVF�果与在TA-UGEF�得的�果相当。 • ULMBET�程持��相��短，并且与TA-UGEF相比�需要一个医��行操作。 • 此外，避免了TA-UGEF所需的��憋尿�患者造成的不适，患者更容易接受ULMb. ET。 • ULMb. ET替代TA-UGEF是可行的，并且在�床�践中可以用于希望移植��合超声的患者。

Large randomized trial comparing transabdominal ultrasound-guided embryo transfer with a technique based on uterine length measurement before embryo transfer Revelli et al. , UOG 2016 �点局限性 • 非劣�性随机�� • 无法使用双盲 • �本量大，充分授� • �施操作的操作�的水平没有分� • 移植�管�一�型的使用 • • 包括了意向性分析和治�分析没有考��床最相关的�局 ——活� 率

UOG期刊俱�部 2: 2016年 9月阴道孕�减少≤ 34周的�胎妊娠和短子��的妊娠�女的早�：包括 OPPTIMUM研究的数据更新的�萃分析 R. Romero, K. H. Nicolaides, A. Conde-Agudelo, J. M. O’Brien, E. Cetingoz, E. Da Fonseca, G. W. Creasy and S. S. Hassan

Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study Romero et al. , UOG 2016 目� �估阴道孕�在�胎妊娠和中期妊娠��度<25 mm的无症状 �女中�防早�，��期�病率和死亡率的�效的最新系��价和�萃分析

Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study Romero et al. , UOG 2016 方法主要�局： • ≤ 34 周的早�或胎儿死亡分析 • 森林�：固定和随机效�模型 • 研究�异�性：Higgin's I 2 • 需要治�的数量的利益或�害的�算 • 基于孕�的日�量的��分析 • Cochrane�作具用于�估偏倚��

Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study Romero et al. , UOG 2016 �果表 3. 阴道孕�≤ 34孕周早�或胎儿死亡的��的效果的森林�

Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study Romero et al. , UOG 2016 局限性 �� • �格的系��价与广泛的文献�索策略 • �果与孕�分�的一致性 • �格的研究偏倚的方法学�估 • ��分析的使用 • 缺乏OPPTIMUM研究中未�告的次要�果的数据 • 没有�表偏倚的正式�估 • OPPTIMUM研究在遵从和�耗偏差有高� � • 缺少个�患者数据