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Fresh embryos versus freeze-all embryos - transfer strategies: Nuances of a meta-analysis.
Dieamant, Felipe C; Petersen, Claudia G; Mauri, Ana L; Comar, V; Mattila, Mariana; Vagnini, Laura D; Renzi, Adriana; Petersen, Bruna; Nicoletti, Andreia; Oliveira, João Batista A; Baruffi, Ricardo Lr; Franco, Jose G.
Afiliação
  • Dieamant FC; Center for Human Reproduction Prof. Franco Jr., Ribeirão Preto, Brazil.
  • Petersen CG; Paulista Center for Diagnosis, Research and Training, Ribeirão Preto, SP, Brazil.
  • Mauri AL; Center for Human Reproduction Prof. Franco Jr., Ribeirão Preto, Brazil.
  • Comar V; Paulista Center for Diagnosis, Research and Training, Ribeirão Preto, SP, Brazil.
  • Mattila M; Center for Human Reproduction Prof. Franco Jr., Ribeirão Preto, Brazil.
  • Vagnini LD; Paulista Center for Diagnosis, Research and Training, Ribeirão Preto, SP, Brazil.
  • Renzi A; Center for Human Reproduction Prof. Franco Jr., Ribeirão Preto, Brazil.
  • Petersen B; Center for Human Reproduction Prof. Franco Jr., Ribeirão Preto, Brazil.
  • Nicoletti A; Paulista Center for Diagnosis, Research and Training, Ribeirão Preto, SP, Brazil.
  • Oliveira JBA; Paulista Center for Diagnosis, Research and Training, Ribeirão Preto, SP, Brazil.
  • Baruffi RL; Paulista Center for Diagnosis, Research and Training, Ribeirão Preto, SP, Brazil.
  • Franco JG; Center for Human Reproduction Prof. Franco Jr., Ribeirão Preto, Brazil.
JBRA Assist Reprod ; 21(3): 260-272, 2017 09 01.
Article em En | MEDLINE | ID: mdl-28837037
OBJECTIVE: The present meta-analysis aimed to evaluate whether the freeze-all strategy (Freeze/All-ET) could bring about improvements in the clinical assisted reproductive technique (ART) outcomes when compared with the fresh embryo transfer strategy (Fresh-ET) in patients undergoing an ART cycle in accordance with the mean number of oocytes collected. METHODS: A systematic review based on electronic searches in databases (PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials) was carried out to identify randomized controlled trails (RCTs) comparing ART outcomes between fresh-embryo transfers versus elective frozen-embryo transfers up to February of 2017. Four reviewers independently evaluated abstracts, validity assessment and data extraction. Odds Ratio (OR) values with a 95% confidence interval (CI), and heterogeneity were evaluated. RESULTS: Five RCTs were included as targets for data extraction and meta-analysis purposes. The results of this meta-analysis were divided into two parts (Freeze/All-ET versus Fresh-ET): Part I- All trials in which the mean number of collected oocytes was >12 and <21 for ongoing pregnancy rate (OR=1.24; 95%CI=1.06-1.44), clinical pregnancy rate (OR=1.19; 95%CI=0.98-1.43), live birth rate (OR= 1.39; 95%CI=0.99-1.95), and miscarriage rate (OR=0.68; 95%CI=0.46-1.00); Part II- Three studies where the mean number of oocytes retrieved was >12 and <15 for ongoing pregnancy rate (OR=1.17; 95%CI=1.00-1.38), clinical pregnancy rate (OR=1.34; 95%CI=0.79-2.28), live birth rate (OR= 1.24; 95%CI=1.00-1.55), and miscarriage rate (RR=0.68; 95%CI=0.46-1.02). CONCLUSIONS: The freeze-all strategy could be favorable when high numbers of oocytes are collected, signaling an association between higher ovarian stimulation and consequent impairment of endometrial receptivity. However, when the mean number of oocytes collected is <15, the freeze-all strategy does not appear to be advantageous.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Resultado da Gravidez / Criopreservação / Transferência Embrionária Tipo de estudo: Clinical_trials / Systematic_reviews Limite: Female / Humans / Pregnancy Idioma: En Revista: JBRA Assist Reprod Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Resultado da Gravidez / Criopreservação / Transferência Embrionária Tipo de estudo: Clinical_trials / Systematic_reviews Limite: Female / Humans / Pregnancy Idioma: En Revista: JBRA Assist Reprod Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil