Author:
Baruffi Ricardo LR,Mauri Ana L,Petersen Claudia G,Nicoletti Andréia,Pontes Anagloria,Oliveira João Batista A,Franco José G
Abstract
Abstract
Background
It has become an accepted procedure to transfer more than one embryo to the patient to achieve acceptable ongoing pregnancy rates. However, transfers of more than a single embryo increase the probability of establishing a multiple gestation. Single-embryo transfer can minimize twin pregnancies but may also lower live birth rates. This meta-analysis aimed to compare current data on single-embryo versus double-embryo transfer in fresh IVF/ICSI cycles with respect to implantation, ongoing pregnancy and live birth rates.
Methods
Search strategies included on-line surveys of databases from 1995 to 2008. Data management and analysis were conducted using the Stats Direct statistical software. The fixed-effect model was used for odds ratio (OR). Fixed-effect effectiveness was evaluated by the Mantel Haenszel method. Seven trials fulfilled the inclusion criteria.
Results
When pooling results under the fixed-effect model, the implantation rate was not significantly different between double-embryo transfer (34.5%) and single-embryo transfer group (34.7%) (P = 0.96; OR = 0.99, 95% CI 0.78, 1.25). On the other hand, double-embryo transfer produced a statistically significantly higher ongoing clinical pregnancy rate (44.5%) than single-embryo transfer (28.3%) (P < 0.0001; OR:2.06, 95% CI = 1.64,2.60). At the same time, pooling results presented a significantly higher live birth rate when double-embryo transfer (42.5%) (P < 0.001; OR: 1.87, 95% CI = 1.44,2.42) was compared with single-embryo transfer (28.4%).
Conclusion
Meta-analysis with 95% confidence showed that, despite similar implantation rates, fresh double-embryo transfer had a 1.64 to 2.60 times greater ongoing pregnancy rate and 1.44 to 2.42 times greater live birth rate than single-embryo transfer in a population suitable for ART treatment.
Publisher
Springer Science and Business Media LLC
Subject
Developmental Biology,Endocrinology,Reproductive Medicine,Obstetrics and Gynaecology
Reference33 articles.
1. Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J: A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod. 1998, 13: 3434-3440. 10.1093/humrep/13.12.3434.
2. Gerris J, De Neubourg D, Mangelschots K, Van Royen E, Meerssche Van de M, Valkenburg M: Prevention of twin pregnancy after in-vitro fertilization or intracytoplasmic sperm injection based on strict embryo criteria: a prospective randomized clinical trial. Hum Reprod. 1999, 14: 2581-2587. 10.1093/humrep/14.10.2581.
3. Land JA, Evers JL: Risks and complications in assisted reproduction techniques: Report of an ESHRE consensus meeting. Hum Reprod. 2003, 18: 455-457. 10.1093/humrep/deg081.
4. Andersen AN, Goossens V, Ferraretti AP, Bhattacharya S, Felberbaum R, Mouzon J, Nygren KG: The European IVF-monitoring (EIM) Consortium, for the European Society of Human Reproduction and Embryology (ESHRE) Assisted reproductive technology in Europe, 2004: results generated from European registers by ESHRE. Hum Reprod. 2008, 23: 1424-1430. 10.1093/humrep/den089.
5. Practice Committee of Society for Assisted Reproductive Technology; Practice Committee of American Society for Reproductive Medicine: Guidelines on number of embryos transferred. Fertil Steril. 2008, 90 (5 Suppl): S163-S164.
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