| Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 17965420 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Evangelos G Papanikolaou; Efstratios M Kolibianakis; Herman Tournaye; Christos A Venetis; Human Fatemi; Basil Tarlatzis; Paul Devroey |
Publication Detail:
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Type: Journal Article; Meta-Analysis; Review Date: 2007-10-26 |
Journal Detail:
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Title: Human reproduction (Oxford, England) Volume: 23 ISSN: 1460-2350 ISO Abbreviation: Hum. Reprod. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-10 Completed Date: 2008-03-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8701199 Medline TA: Hum Reprod Country: England |
Other Details:
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Languages: eng Pagination: 91-9 Citation Subset: IM |
Affiliation:
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Centre for Reproductive Medicine, University Hospital, Vrije Univestiteit Brussel (Free University of Brussels), Laarbeeklaaan 101, B-1090 Brussels, Belgium. evangelos.papanikolaou@vub.ac.be / |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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