The University of Southampton
University of Southampton Institutional Repository

What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis

What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis
What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis
Background: frozen–thawed embryo transfer (FET) enables surplus embryos derived from IVF or IVF-ICSI treatment to be stored and transferred at a later date. In recent years the number of FET cycles performed has increased due to transferring fewer embryos per transfer and improved laboratory techniques. Currently, there is little consensus on the most effective method of endometrium preparation prior to FET.

Methods: using both MEDLINE and EMBASE database a systematic review and meta-analysis of literature was performed. Case-series, case–control studies and articles in languages other than English, Dutch or Spanish were excluded. Those studies comparing clinical and ongoing pregnancy rates as well as live birth rates in (i) true natural cycle FET (NC-FET) versus modified NC-FET, (ii) NC-FET versus artificial cycle FET (AC-FET), (iii) AC-FET versus artificial with GnRH agonist cycle FET and (iv) NC-FET versus artificial with GnRH agonist cycle FET were included. Forest plots were constructed and relative risks or odds ratios were calculated.

Results: a total of 43 publications were selected for critical appraisal and 20 articles were included in the final review. For all comparisons, no differences in the clinical pregnancy rate, ongoing pregnancy rate or live birth rate could be found. Based on information provided in the articles no conclusions could be drawn with regard to cancellation rates.

Conclusions: based on the current literature it is not possible to identify one method of endometrium preparation in FET as being more effective than another. Therefore, all of the current methods of endometrial preparation appear to be equally successful in terms of ongoing pregnancy rate. However, in some comparisons predominantly retrospective studies were included leaving these comparisons subject to selection and publication bias. Also patients' preferences as well as cost-efficiency were not addressed in any of the included studies. Therefore, prospective randomized studies addressing these issues are needed
1355-4786
458-470
Groenewoud, E.R.
c222aa20-07ea-4e38-9742-026977f3214a
Cantineau, A.E.
5e41632c-d9c8-462e-8cc4-1463d7966bbf
Kollen, B.J.
6c9f17ee-54f0-47d0-bbe3-120bdc4cba0e
Macklon, N.S.
7db1f4fc-a9f6-431f-a1f2-297bb8c9fb7e
Cohlen, B.J.
7219953c-44d4-45dd-a925-e45809d17483
Groenewoud, E.R.
c222aa20-07ea-4e38-9742-026977f3214a
Cantineau, A.E.
5e41632c-d9c8-462e-8cc4-1463d7966bbf
Kollen, B.J.
6c9f17ee-54f0-47d0-bbe3-120bdc4cba0e
Macklon, N.S.
7db1f4fc-a9f6-431f-a1f2-297bb8c9fb7e
Cohlen, B.J.
7219953c-44d4-45dd-a925-e45809d17483

Groenewoud, E.R., Cantineau, A.E., Kollen, B.J., Macklon, N.S. and Cohlen, B.J. (2013) What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis. Human Reproduction Update, 19 (5), 458-470. (doi:10.1093/humupd/dmt030). (PMID:23820515)

Record type: Article

Abstract

Background: frozen–thawed embryo transfer (FET) enables surplus embryos derived from IVF or IVF-ICSI treatment to be stored and transferred at a later date. In recent years the number of FET cycles performed has increased due to transferring fewer embryos per transfer and improved laboratory techniques. Currently, there is little consensus on the most effective method of endometrium preparation prior to FET.

Methods: using both MEDLINE and EMBASE database a systematic review and meta-analysis of literature was performed. Case-series, case–control studies and articles in languages other than English, Dutch or Spanish were excluded. Those studies comparing clinical and ongoing pregnancy rates as well as live birth rates in (i) true natural cycle FET (NC-FET) versus modified NC-FET, (ii) NC-FET versus artificial cycle FET (AC-FET), (iii) AC-FET versus artificial with GnRH agonist cycle FET and (iv) NC-FET versus artificial with GnRH agonist cycle FET were included. Forest plots were constructed and relative risks or odds ratios were calculated.

Results: a total of 43 publications were selected for critical appraisal and 20 articles were included in the final review. For all comparisons, no differences in the clinical pregnancy rate, ongoing pregnancy rate or live birth rate could be found. Based on information provided in the articles no conclusions could be drawn with regard to cancellation rates.

Conclusions: based on the current literature it is not possible to identify one method of endometrium preparation in FET as being more effective than another. Therefore, all of the current methods of endometrial preparation appear to be equally successful in terms of ongoing pregnancy rate. However, in some comparisons predominantly retrospective studies were included leaving these comparisons subject to selection and publication bias. Also patients' preferences as well as cost-efficiency were not addressed in any of the included studies. Therefore, prospective randomized studies addressing these issues are needed

This record has no associated files available for download.

More information

Published date: 2013
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 359608
URI: http://eprints.soton.ac.uk/id/eprint/359608
ISSN: 1355-4786
PURE UUID: ed9cd9b4-bcb3-4d53-bab9-9814dca01fa1

Catalogue record

Date deposited: 07 Nov 2013 11:52
Last modified: 27 Apr 2022 10:59

Export record

Altmetrics

Contributors

Author: E.R. Groenewoud
Author: A.E. Cantineau
Author: B.J. Kollen
Author: N.S. Macklon
Author: B.J. Cohlen

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×