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Immunosuppressants in women with repeated implantation failure in assisted reproductive techniques: a systematic review and meta-analysis.
Santos, Ana Clara Felix de Farias; Zamora, Fernanda Valeriano; Al-Sharif, Lubna; Sehgal, Kush; Cavalcante, Deyvid Vieira Silva; Ferreira, Sarah Hasimyan; da Silva, Pedro Henrique Costa Matos.
Affiliation
  • Santos ACFF; Universidade Cidade de São Paulo São PauloSP Brazil Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
  • Zamora FV; Universidade Federal de Minas Gerais Belo HorizonteMG Brazil Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
  • Al-Sharif L; An-Najah National University NablusWB Palestine An-Najah National University, Nablus, WB, Palestine.
  • Sehgal K; Teerthanker Mahaveer University MoradabadUP India Teerthanker Mahaveer University, Moradabad, UP, India.
  • Cavalcante DVS; Universidade CEUMA São LuisMA Brazil Universidade CEUMA, São Luis, MA, Brazil.
  • Ferreira SH; Departamento de Ginecologia e Obstetrícia Faculdade de Medicina Universidade Federal de Goiás GoiâniaGO Brazil Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brazil.
  • da Silva PHCM; Departamento de Ginecologia e Obstetrícia Faculdade de Medicina Universidade Federal de Goiás GoiâniaGO Brazil Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Article in En | MEDLINE | ID: mdl-39380592
ABSTRACT

Objective:

To compare outcomes in patients with repeated implantation failure undergoing Intracytoplasmic Sperm Injection/In vitro fertilization (IVF/ICSI) plus immunosuppressants such as prednisolone, prednisone, or cyclosporine A versus the use of IVF/ICSI alone. Data source Databases were systematically searched in PubMed, Cochrane, and Embase databases in September 2023. Study Selection Randomized clinical trials and observational studies with the outcomes of interest were included. Data collect We computed odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics. Data were analyzed using Review Manager 5.4.The main outcomes were live birth, miscarriage, implantation rate, clinical pregnancy, and biochemical pregnancy. Data

synthesis:

Seven studies with 2,829 patients were included. Immunosuppressive treatments were used in 1,312 (46.37%). Cyclosporine A improved implantation rate (OR 1.48; 95% CI 1.01-2.18) and clinical pregnancy (1.89, 95% CI 1.14-3.14). Compared to non-immunosuppressive treatment, prednisolone and prednisone did not improve live birth (OR 1.13, 95% CI 0.88-1.46) and miscarriage (OR 1.49, 95% CI 1.07-2.09). Prednisolone showed no significant effect in patients undergoing IVF/ICSI, clinical pregnancy (OR 1.34; 95% CI 0.76-2.36), or implantation rate (OR 1.36; 95% CI 0.76-2.42).

Conclusion:

Cyclosporine A may promote implantation and clinical pregnancy rates. However, given the limited sample size, it is important to approach these findings with caution. Our results indicate that prednisolone and prednisone do not have any beneficial effects on clinical outcomes of IVF/ICSI patients with repeated implantation failure. PROSPERO CRD42023449655.
Subject(s)
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Embryo Implantation / Immunosuppressive Agents Limits: Female / Humans / Pregnancy Language: En Journal: Rev Bras Ginecol Obstet Journal subject: GINECOLOGIA / OBSTETRICIA Year: 2024 Document type: Article Affiliation country: Brazil Country of publication: Brazil

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Embryo Implantation / Immunosuppressive Agents Limits: Female / Humans / Pregnancy Language: En Journal: Rev Bras Ginecol Obstet Journal subject: GINECOLOGIA / OBSTETRICIA Year: 2024 Document type: Article Affiliation country: Brazil Country of publication: Brazil