The Effect Of Growth Hormone On The Endometrium And Pregnancy Outcome Of Thin Endometrium Patients During Frozen-thawed Embryo Transfer Cycle:a Meta-analysis

Objective:To evaluate the effect of growth hormone(GH)on endometrium and pregnancy outcome of thin endometrium patients during frozen-thawed embryo transfer cycle by meta analysis.Method: General databases were searched comprehensively.It includes the English databases EMbase,Cochrane Library,PubMed,Web of science,and the Chinese database China Knowledge Network(CNKI),Wanfang Database,and Weipu Chinese Science and Technology Periodical Database(VIP).Collecting all published literature on the effects of growth hormone on endometrium and(or)pregnancy outcomes of thin endometrium patients.Two researchers screened the literature in strict accordance with the inclusion and exclusion criteria,and performed data extraction and entry of the included literature.At the same time,they applied the Cochran collaborative network RCT bias risk assessment tool for quality evaluation.They used Stata15.0 statistical software for meta-analysis,to evaluate endometrial thickness on transplantation day,three-line type Endometrial rate,endometrial and subendometrial blood flow rate,embryo implantation rate,clinical pregnancy rate and abortion rate.To calculated odds ratio(OR),weighted mean difference(WMD)and other indicators for combined analysis of data.The Funnel plot,Egger and Begg tests were performed to detect publication bias,and the sensitivity analysis was used to judge the stability of the research results.To evaluate the effect of growth hormone on endometrial and pregnancy outcome of thin endometrial patients during frozen-thawed embryo transfer cycle.Results: After screening for inclusion criteria,a total of 7 articles were included.There are 6 Chinese literatures and 1 English literature,which contains a total of 501 samples,including 259 in the GH group and 242 in the control group.Meta analysis results show that endometrial thickness in GH group on transplantation day [WMD = 1.34(95% CI: 1.01,1.67)],three-line type Endometrial rate [OR = 3.18(95% CI: 1.77,5.70)],endometrial and subendometrial blood flow [OR = 4.13(95% CI: 2.33,7.65)],embryo implantation rate [OR = 2.07(95% CI: 1.41,3.03)],clinical pregnancy rate [OR = 2.43(95% CI: 1.66,3.57)] were significantly higher than the control group,and the difference was statistically significant(P <0.05)..The combined effect of abortion rate OR = 0.37(95% CI: 0.13,1.03),indicating that abortion rate in GH group was lower than that in control group,but the difference was not statistically significant(P> 0.05).The Funnel plot,Begg and Egger test results showed that there was no significant publication bias for all indicators(P> 0.05).Finally,the sensitivity analysis was performed by excluding the articles one by one and recording the changes in the combined effect value.With the exception of abortion rates,any study is removed and the results of the study will not change qualitatively.However,after omitting Li Weiwei's(2019)study for abortion rates,the combined results changed from no statistical significance to statistical significance.Conclusion: Growth hormone can increase the thickness of endometrium in patients with thin endometrium,increase the proportion of triple-line endometrium,increase the endometrial and subendometrial blood flow rateand,improve endometrial receptivity during frozen-thawed embryo transfer cycle;Growth hormone can improve the pregnancy outcome of patients with thin endometrium,increase embryo implantation rate,increase clinical pregnancy rate during frozen-thawed embryo transfer cycle,and so on.