Abstract
BackgroundSequential embryo transfer has been proposed as a way to improve embryo implantation in women for in vitro fertilization (IVF), but the effect on pregnancy outcomes remains ambiguous. This systematic review was conducted to investigate the efficacy of sequential embryo transfer on IVF outcomes.MethodsA literature search was performed in the PubMed, Web of Science, Cochrane Library, ScienceDirect and Wanfang databases. Data were pooled using a random- or fixed-effects model according to study heterogeneity. The results are expressed as relative risks (RRs) with 95% confidence intervals (CIs). Heterogeneity was evaluated by the I2 statistic. The study protocol was registered prospectively on INPLASY, ID: INPLASY202180019.ResultsTen eligible studies with 2658 participants compared sequential embryo transfer and cleavage transfer, while four studies with 513 participants compared sequential embryo transfer and blastocyst transfer. The synthesis results showed that the clinical pregnancy rate was higher in the sequential embryo transfer group than in the cleavage embryo transfer group (RR 1.42, 95% CI 1.26–1.60, P< 0.01) for both women who did experience repeated implantation failure (RIF) (RR 1.58, 95% CI 1.17–2.13, P< 0.01) and did not experience RIF (Non-RIF) (RR 1.44, 95% CI 1.20–1.66, P< 0.01). However, sequential embryo transfer showed no significant benefit over blastocyst embryo transfer.ConclusionThe current systematic review demonstrates that sequential cleavage and blastocyst embryo transfer improve the clinical pregnancy rate over conventional cleavage embryo transfer. For women with adequate embryos, sequential transfer could be attempted following careful consideration. More high-grade evidence from prospective randomized studies is warranted.
Highlights
Sequential embryo transfer has been proposed as a way to improve embryo implantation in women for in vitro fertilization (IVF), but the effect on pregnancy outcomes remains ambiguous
The results showed a statistically significant improvement in the chemical pregnancy rate in the sequential transfer group (RR=1.59, 95% Confidence interval (CI) 1.21–2.09, P< 0.01; Table 2)
The results showed no significant difference between the sequential transfer and blastocyst transfer groups under a random-effects model (RR 1.29, 95% CI 0.90–1.85, P = 0.17; Table 3)
Summary
Sequential embryo transfer has been proposed as a way to improve embryo implantation in women for in vitro fertilization (IVF), but the effect on pregnancy outcomes remains ambiguous. This systematic review was conducted to investigate the efficacy of sequential embryo transfer on IVF outcomes. In vitro fertilization and embryo transfer (IVF-ET) technology is an important choice for infertile couples. Embryo implantation is a complex process involving multiple biological factors [2], requiring embryos with high developmental potential, good endometrial receptivity and effective dialogue between the two [3]. Determining how to adjust the embryo transfer strategy, make good use of existing embryos, and obtain ideal outcomes is a common problem faced by reproductive doctors and embryologists. The developmental potential of current high-quality embryos, selected by morphology
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
