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The effect of intravenous immunoglobulin passive immunotherapy on unexplained recurrent spontaneous abortion: a meta-analysis  Si-Wei Wang, Song-Yang.

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Presentation on theme: "The effect of intravenous immunoglobulin passive immunotherapy on unexplained recurrent spontaneous abortion: a meta-analysis  Si-Wei Wang, Song-Yang."— Presentation transcript:

1 The effect of intravenous immunoglobulin passive immunotherapy on unexplained recurrent spontaneous abortion: a meta-analysis  Si-Wei Wang, Song-Yang Zhong, Li-Jun Lou, Ze-Fu Hu, Hua-Yu Sun, Hai-Yan Zhu  Reproductive BioMedicine Online  Volume 33, Issue 6, Pages (December 2016) DOI: /j.rbmo Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

2 Figure 1 Article selection.
Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

3 Figure 2 Risk of bias assessment summary for each included study. + = low risk of bias; ? = unclear risk of bias. Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

4 Figure 3 Risk of bias assessment for all included studies.
Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

5 Figure 4 Live birth rate between intravenous immunoglobulin treatment and placebo groups in patients who have experienced recurrent spontaneous abortion. Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

6 Figure 5 Cumulative meta-analysis of randomized trials comparing intravenous immunoglobulin with placebo in patientw who have experienced unexplained recurrent spontaneous abortion. IVIG, intravenous immumoglobulin; RR, relative risk. Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

7 Figure 6 Trial sequential analysis of all included studies on the effect of intravenous immunoglobulin on live birth rate in unexplained recurrent spontaneous abortion patients. A diversity-adjusted required information size of 1848 patients was calculated on the basis of a live birth rate of 52.98% in the control group, relative risk reduction of 20%, α = 5% (two-sided), and β = 20%. The cumulative Z-curve did not cross the trial sequential monitoring boundaries for benefits, harms, or futility, and the required information size was not reached. Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

8 Figure 7 Comparison of primary and secondary recurrent spontaneous abortion in intravenous immunoglobulin treated and placebo groups. Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

9 Figure 8 Cumulative meta-analysis of randomized trials comparing intravenous immunoglobulin with placebo in secondary recurrent spontaneous abortion patients. Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

10 Figure 9 Trial sequential analysis of the effect of intravenous immunoglobulin on live birth rate in secondary recurrent spontaneous abortion patients. A diversity-adjusted required information size of 811 patients was calculated on the basis of a live birth rate of 58.59% in the control group, relative risk reduction of 20%, α = 5% (two-sided), and β = 20%. The cumulative Z-curve did not cross the trial sequential monitoring boundaries for benefits, harms, or futility, and the required information size was not reached. IVIG, intravenous immunoglobulin. Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

11 Figure 10 Comparison of live birth rate between pre-conception and post-implantation intravenous immunoglobulin administration. CI, confidence interval. Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

12 Figure 11 Sensitivity analysis for all included studies.
Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

13 Figure 12 Assessment of publication biases. RR, relative risk; SE, standard error. Reproductive BioMedicine Online  , DOI: ( /j.rbmo ) Copyright © 2016 Reproductive Healthcare Ltd. Terms and Conditions

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