Follicular Fluid Meiosis-Activating Sterol in Assisted Reproductive Techniques: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Author:

Dang Kien Nguyen12,Hashan Mohammad Rashidul13,Minh Le Huu Nhat14,Khalaf Khalid Muhammad15,Ibrahim Hassan Yousif16,Dessi Alberto17,Azzam Mohamed Abdalla18,Loc Tran Thai Huu19,Hirayama Kenji110,Huy Nguyen Tien11

Affiliation:

1. Online Research Club (), Nagasaki, Japan

2. Department of Obstetrics and Gynecology, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam

3. Bangladesh Civil Service, Ministry of Health and Family Welfare, Government of Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh

4. Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam

5. Kasr Al Ainy, Faculty of Medicine, Cairo University, Egypt

6. Faculty of Medicine, Sohag University, Egypt

7. Medicine and Surgery, Universita Degli Studi di Sassari (UNISS), Sassari, Italy

8. Faculty of Medicine, Zagazig University, Egypt

9. School of Medicine, Vietnam National University Ho Chi Minh City, Vietnam

10. Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Leading Graduate School Program, and Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan

11. Department of Clinical Product Development, Institute of Tropical Medicine (NEKKEN), School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan

Abstract

Background: Follicular fluid meiosis-activating sterol (FFMAS) is one of several molecular compounds that has been added into in vitro maturation (IVM) technique with contradictory results. Our study aimed to investigate the effects of FFMAS in assisted reproductive technology (ART). Methods: We searched systematically in PubMed, Web of Science, Scopus, Cochrane Registry of clinical trials, WHO registry of clinical trials, clinicaltrials.gov, Google Scholar until July 2017. Meta-analysis was used to investigate the efficacy and safety outcomes of FFMAS. Following the retrieval of potential articles, two independent reviewers screened and extracted included papers rigorously. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were computed for the individual outcome when data was available. Quality of included studies was assessed using Cochrane collaboration tool. Results: A total of seven randomized controlled trials involving 1198 participants with 3105 oocytes were explored in this study. Most of the studies were at low risk of bias. Our random effects model meta-analyses in maturation and abnormal embryo rate between FFMAS-exposed oocytes compared with controls revealed no significant differences (summary OR 1.00, 95% CI 0.46–2.16, [Formula: see text] value = 0.99 and summary OR was 1.31, 95% CI 0.84–2.04, [Formula: see text] value = 0.23, respectively). Beside, our study showed a significant increase in uniformly abnormal embryo rate in FFMAS group compared with vehicle control group (summary OR 1.98, 95% CI 1.09–3.61, [Formula: see text] value = 0.03). No significances were noted on meta-analyses of normal embryo rate, uniformly abnormal embryo rate, uniformly normal embryo rate, mosaic embryo rate, abnormal blastomere rate, normal blastomere rate, aneuploidy mosaic embryo rate, and chaotic mosaic embryo rate. Conclusions: FFMAS showed no efficacy in maturation process in human oocytes and there was some evidence for detrimental effects in comparison to vehicle controls. We discouraged any further trials due to safety concern.

Publisher

World Scientific Pub Co Pte Lt

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