Document Detail


Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis.
MedLine Citation:
PMID:  17965420     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Both cleavage-stage and blastocyst-stage embryo transfer policies have advantages and drawbacks. The number of embryos transferred, however, is a crucial parameter that needs to be considered before attempting any comparison. METHODS: An extensive literature search yielded initially 282 studies from which 8 randomized controlled trials met the inclusion criteria: (i) truly randomized design (ii) policy to transfer equal number of embryos in both the cleavage-stage and the blastocyst-stage groups and (iii) published as full text in a peer-review journal. Primary outcome was the live birth rate and secondary outcomes were clinical pregnancy rate, multiple pregnancy rate, cancellation rate and cryopreservation rate. RESULTS: A total of 1654 patients were reviewed. Live birth rate per randomized patient was significantly higher (n = 6 studies) in patients who had a blastocyst-stage transfer as compared to patients with cleavage-stage embryo transfer [odds ratio (OR): 1.39, 95% confidence interval (CI): 1.10-1.76; P = 0.005]. Clinical pregnancy rate (OR: 1.27, 95% CI: 1.03-1.55; P = 0.02) and cancellation rate per patient randomized (OR: 2.21, 95% CI: 1.47-3.32; P = 0.0001) were significantly higher in patients with a blastocyst-stage embryo transfer as compared to patients in whom a cleavage-stage embryo transfer was performed. The cryopreservation rate was significantly higher in the cleavage-stage group (OR: 0.28, 95% CI: 0.14-0.55; P = 0.0002). CONCLUSIONS: The best available evidence suggests that the probability of live birth after fresh IVF is significantly higher after blastocyst-stage embryo transfer as compared to cleavage-stage embryo transfer when equal number of embryos are transferred in the two groups compared.
Authors:
Evangelos G Papanikolaou; Efstratios M Kolibianakis; Herman Tournaye; Christos A Venetis; Human Fatemi; Basil Tarlatzis; Paul Devroey
Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2007-10-26
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  23     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-10     Completed Date:  2008-03-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  91-9     Citation Subset:  IM    
Affiliation:
Centre for Reproductive Medicine, University Hospital, Vrije Univestiteit Brussel (Free University of Brussels), Laarbeeklaaan 101, B-1090 Brussels, Belgium. evangelos.papanikolaou@vub.ac.be /
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MeSH Terms
Descriptor/Qualifier:
Birth Rate*
Blastocyst*
Cleavage Stage, Ovum*
Embryo Transfer*
Female
Fertilization in Vitro*
Humans
Live Birth*
Pregnancy
Pregnancy Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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