| Objectives To summarize outcome indicators through Meta-analysis and compare the effects of programmed and vitrified freezing on human kinds ovarian tissue,to provide evidence-based evidence for clinical ovarian tissue freezing.Methods To retrieve randomized controlled tests published in Chinese Internet databases(CNKI,Wan Fang,VIP,CBM),The Chinese Clinical Trials Registration Center,English Internet databases(Pubmed,The Cochrane Library,Embase,Web of Science),and The American Clinical Trials Registration Center.The retrieval time was set from the time the database was established to December 1,2020.The retrieval pattern was"subject words and free words".The Cochrane Library bias risk assessment tool and the modified Jadad scales were used to evaluate the study quality.The main outcomes included the proportion of primordial follicles,the proportion of primary follicles,the normal rate of primordial follicles,the normal rate of primary follicles,the apoptosis rate of primordial follicles,the serum E2 level of xenotransplantation mice,and the density of primordial follicles.Retrieval,screening,quality assessment,and data extraction were conducted by two researchers independently.The extracted data were statistically analyzed using Review Manager5.4 and Stata16.Fixed or random-effects models and 95%confidence interval(CI)were used to evaluate the relative risk(RR).Results In this Meta-analysis,a total of 11 studies were included,including 8 in Chinese and 3 in English,all of which were randomized controlled studies.The total sample size was 163 cases.Five of the studies compared the proportion of primordial follicles between the programmed cryopreservation group and the vitrification group.The number of follicles in the programmed cryopreservation group was 1081,while that in the vitrification group was 1163.There was no statistical difference in the results,RR=1.00,95%CI(0.97,1.03),P=0.84,I~2=0%;Fixed effect model;Z=0.06,P=0.95.Four studies compared the proportion of primary follicles between the programmed cryopreservation group and the vitrification cryopreservation group.The number of follicles in the programmed cryopreservation group was 1040,while that in the vitrification cryopreservation group was 1126.There was no statistical difference in the results,RR=1.03,95%CI(0.83,1.28),P=0.83,I~2=0%;Fixed effect model;Z=0.28,P=0.78.Eight studies compared the normal rate of intact primordial follicles between the programmed cryopreservation group and the vitrified group,the number of follicles in the programmed cryopreservation group was 1405,while that in the vitrification group was 1387,and the results showed great heterogeneity(P<0.00001)and I~2=81%.When one of the studies was eliminated by the elimination method one by one,the remaining data no longer showed heterogeneity and the results were statistically different,RR=0.92,95%CI(0.88,0.96),P=0.38,I~2=6%;Fixed effect model;Z=3.58,P=0.003.Six studies compared the proportion of intact normal primary follicles between the programmed cryopreservation group and the vitrification cryopreservation group,the number of follicles in the programmed cryopreservation group was 225,while that in the vitrification group was 206,and the results showed no statistically significant difference,RR=0.96,95%CI(0.81,1.12),P=0.21,I~2=30%;Fixed effect model;Z=0.56,P=0.58.Three studies compared the proportion of original follicle apoptosis between the programmed cryopreservation group and the vitrification group,the number of follicles in the programmed cryopreservation group was293,while that in the vitrification group was 305,and the results showed no statistically significant difference,RR=0.94,95%CI(0.73,1.23),P=0.25,I~2=28%;Fixed effect model;Z=0.43,P=0.67.Two studies compared serum E2 levels of xenotransplantation mice in the programmed freezing group and the vitrification freezing group,the number of follicles in the programmed cryopreservation group was 23,while that in the vitrification group was23,and the results showed no statistically significant difference,MD=-0.67,95%CI(-3.44,2.11),P=0.95,I~2=0%;Fixed effect model;Z=0.47,P=0.64.Two studies compared the original follicle density between the programmed cryopreservation group and the vitrification group,the number of follicles in the programmed cryopreservation group was33,while that in the vitrification group was 33,and the results showed no statistical difference,MD=-0.11,95%CI(-0.76,0.54),P=1.00,I~2=0%;Fixed effect model;Z=0.33,P=0.74).Conclusions Vitrification may be more effective than programmed freezing in preserving the intact primordial follicles,but there is no significant difference in other aspects.Large samples and high-quality studies are required clarifying the better method of ovarian tissue cryopreservation.Figure 17;Table 2;Reference 118... |
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