Page 90 - 《中国药房》2020年22期

·循证药学·

重组人促卵泡激素对比尿促卵泡素在体外受精/卵胞质内单精子

注射-胚胎移植中促排卵治疗的快速卫生技术评估 Δ

张若梅 1，2＊ ，吴 斌 ，金 丽 （1.上海交通大学医学院附属仁济医院药剂科，上海 200127；2.上海交通大学医
3 #
1
学院附属国际和平妇幼保健院药剂科，上海 200030；3.上海交通大学医学院附属国际和平妇幼保健院不孕不
育科，上海 200030）

中图分类号 R956 文献标志码 A 文章编号 1001-0408（2020）22-2768-06
DOI 10.6039/j.issn.1001-0408.2020.22.14

摘 要 目的：比较重组人促卵泡激素（rFSH）和尿促卵泡素（uFSH）在体外受精/卵胞质内单精子注射-胚胎移植（IVF/ICSI-ET）中
促排卵治疗的有效性、安全性和经济性，为rFSH和uFSH的临床合理使用提供循证证据。方法：计算机检索PubMed、Embase、Co-
chrane图书馆、中国知网、维普网、万方数据以及专业的卫生技术评估（HTA）数据库，收集rFSH对比uFSH在IVF/ICSI-ET中促排
卵治疗的 HTA、系统评价/Meta 分析和经济学研究。筛选文献、提取资料、评价质量后，采用定性描述的方法汇总纳入研究的结
论。结果：共纳入7篇文献，包括2篇系统评价/Meta分析和5篇经济学评价，未检索到HTA报告，所有研究均来自国外报道。系统
评价/Meta分析发现，rFSH组在控制性促排卵中的获卵数较uFSH组多；而两组的持续妊娠率、临床妊娠率、活产率、流产率和卵巢
过度刺激综合征发生率比较差异均无统计学意义（P＞0.05）。经济学研究显示，rFSH可能更具成本-效果优势。结论：目前可获得
的证据支持将rFSH用于IVF/ICSI-ET的促排卵治疗，uFSH的疗效和安全性与其相当，且rFSH可能更具成本-效果优势。
关键词 重组人促卵泡激素；尿促卵泡素；快速卫生技术评估；体外受精/卵胞质内单精子注射-胚胎移植；促排卵治疗；疗效；安全
性；经济性
Rapid Health Technology Assessment of Recombinant FSH versus Urine FSH in Ovulation Induction
Therapy for in vitro Fertilization/intracytoplasmic Sperm Injection-embryo Transfer
3
1，2
ZHANG Ruomei ，WU Bin ，JIN Li（1. Dept. of Pharmacy，Renji Hospital，Shanghai Jiaotong University
1
School of Medicine，Shanghai 200127，China；2. Dept. of Pharmacy，International Peace Maternity and Child
Health Hospital，Shanghai Jiaotong University School of Medicine，Shanghai 200030，China；3. Dept. of
Infertility，International Peace Maternity and Child Health Hospital，Shanghai Jiaotong University School of
Medicine，Shanghai 200030，China）

ABSTRACT OBJECTIVE：To compare the efficacy，safety and economics of recombinant human follicle stimulating hormone
（rFSH）and urin follicle stimulating hormone（uFSH）in the ovulation induction therapy for in vitro fertilization/intracytoplasmic
sperm injection-embryo transfer，and to provide evidence-based evidence for rational use of rFSH in the clinic. METHODS：
Retrieved from PubMed，Embase，the Cochrane Library，CNKI，VIP，Wanfang database as well as professional health technology
assessment（HTA）database，HTA，systematic review/Meta-analysis and economic studies were collected to compare the effects of
rFSH versus urine FSH （uFSH） in ovulation induction for in vitro fertilization/intracytoplasmic sperm injectionembryo transfer
（IVF/ICSI-ET）. After literature screening，data extiaction and quality evaluation，the conclusions of the included studies were
summarized by using qualitative description. RESULTS：A total of 7 literatures were included，involving 2 systematic reviews/
Meta-analysis and 5 economic evaluations，and no HTA report was retrieved. All the studies were reported from abroad. Systematic
evaluation/Meta-analysis showed that the number of oocytes obtained in the rFSH group was higher than that in the uFSH group.
There was no statistical significance in persistent pregnancy rate，clinical pregnancy rate，live birth rate，abortion rate and the
incidence of ovarian hyperstimulation syndrome（OHSS）between 2 groups（P＞0.05）. Economic research showed that rFSH may
have cost-effective advantage. CONCLUSIONS：Current available evidence support that rFSH has simialr efficacy and safety for
ovulation induction of IVF/ICSI-ET， and shows cost-effec-
Δ 基金项目：国家自然科学基金资助项目（No.81871140） tiveness advantage.
＊主管药师，硕士研究生。研究方向：药物经济学。电话：021-
KEYWORDS Recombinant FSH；Urine FSH；Rapid health
64070434-30118。E-mail：luny@163.com
technology assessment； IVF/ICSI-ET； Ovulation induction
# 通信作者：副主任药师，博士。研究方向：药物经济学、循证药
therapy；Efficacy；Safety；Economics
学、卫生技术评估、临床与卫生决策。电话：021-68383427。E-mail：
withtop@126.com

·2768 · China Pharmacy 2020 Vol. 31 No. 22 中国药房 2020年第31卷第22期