Effects of atosiban on uterine peristalsis following frozen embryo transfer: A randomized controlled trial

Buddhabunyakan, Nattapong; Sothornwit, Jen; Seejorn, Kanok; Buppasiri, Pranom; Salang, Lingling

doi:10.1016/j.ejogrb.2021.08.017

Cited by 13 publications

(8 citation statements)

References 26 publications

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“…As EP risks were higher for patients with an EMT of < 8 mm, especially when the transferred embryos were in the cleavage stage or when multiple embryos were transferred, such patients should be given clear advice. Furthermore, it should be carefully decided whether frozen ET should be performed in the current cycle while routinely examining the endometrial peristaltic wave ( 49 , 52 ) and providing appropriate treatments such as phloroglucinol ( 53 ) and atosiban ( 54 ) when necessary as these would help in preventing EP or diagnosing the condition at an early stage.…”

Section: Discussionmentioning

confidence: 99%

An Endometrial Thickness < 8 mm Was Associated With a Significantly Increased Risk of EP After Freeze-Thaw Transfer: An Analysis of 5,960 Pregnancy Cycles

Zhao

Liu

et al. 2022

Front. Endocrinol.

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IntroductionEndometrium characteristics that are most likely to induce ectopic pregnancy were investigated on the basis of the data of 5,960 pregnant freeze-thaw cycles.MethodsA total of 5,960 pregnancy cycles after freeze-thaw embryos transfer were included, with the number of intrauterine and ectopic pregnancies being 5,777 and 183, respectively. Ectopic pregnancy was the primary outcome. Endometrial thickness was the main measured variable. The risk factors of ectopic pregnancy were eventually determined based on univariate analysis and subsequent multiple-stepwise logistic regression analysis.Results1. After adjusting for confounders, endometrial thickness could independently predict ectopic pregnancy. The adjusted odd ratios for women with endometrial thickness in the ranges of < 8 mm, 8–9.9 mm, and 10–11.9 mm were 3.270 [95% confidence interval (CI), 1.113–9.605, P = 0.031], 2.758 (95% CI, 0.987–7.707, P = 0.053), and 1.456 (95% CI, 0.502–4.225, P = 0.489), respectively, when compared with those having an endometrial thickness of 12–13.9 mm. 2. Endometrial type and preparation protocol were however not identified as risk factors for ectopic pregnancy.Discussion1. After freeze-thaw embryo transfer, risks of ectopic pregnancy were significantly higher when the endometrial thickness was < 8 mm. 2. A thin endometrial thickness could be linked with abnormal endometrial peristaltic waves or abnormal endometrial receptivity. 3. Adequate attention should therefore be paid to patients with a thin endometrial thickness to prevent EP or to achieve early diagnosis during the peri-transplantation period.

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Section: Discussionmentioning

confidence: 99%

An Endometrial Thickness < 8 mm Was Associated With a Significantly Increased Risk of EP After Freeze-Thaw Transfer: An Analysis of 5,960 Pregnancy Cycles

Zhao

Liu

et al. 2022

Front. Endocrinol.

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“…The lack of sufficient data on age in included studies meant that age specific analyses could not be performed. It has previously been indicated that the addition of atosiban to FET cycles did not decrease uterine peristalsis, but may be beneficial to the group of advanced age (60). It will be more accurate and objective if the clinical trial can be carried out by age groups.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of atosiban for repeated embryo implantation failure: A systematic review and meta-analysis

et al. 2023

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BackgroundRepeated embryo implantation failure (RIF) posed a significant challenge in assisted reproduction. Evidence of its therapeutic effectiveness including atosiban used around embryo transfer to improve pregnancy outcomes in RIF patients undergoing in vitro fertilization-embryo transfer (IVF-ET) remained inconsistent. This study aimed to explore the efficacy of atosiban on pregnancy outcomes of patients with RIF who received IVF-ET. MethodsThe research was designed using the PICOS format. A systematic search of four English databases, PubMed, EMBASE, Web of Science, Cochrane Library, and one Chinse database, China National Knowledge Infrastructure (CNKI) was conducted. The time range was from inception to December 10, 2022. Then trials comparing the efficacy of atosiban and control group on pregnancy outcomes in RIF patients who receive IVF-ET were included. Subgroup analysis and sensitivity analysis were performed to reduce the influence of heterogeneity between included studies. Risk ratio (RR) and 95% confidence interval (CI) were calculated. The main outcome measure was clinical pregnancy rate (CPR). For the analyses, StataMP 17.0 (Stata Corporation, USA) was used.ResultsTwo prospective randomized controlled trials (RCTs), one prospective cohort study and four retrospective cohort studies were included. Our results showed that atosiban was associated with higher clinical pregnancy rate (RR=1.54, 95% CI: 1.365–1.735, P < 0.001, I2 = 0.0%). The results of subgroup analysis based on study types (prospective randomized controlled clinical trial, retrospective cohort study and prospective cohort study) showed that in all types of studies, CPR of atosiban group was significantly higher than controlled group. The results of subgroup analysis based upon the diagnostic criteria of number of previous embryo transfer failures showed that the intervention of atosiban improved the CPR whether in participants with 2 previous ET failures or in participants with 3 previous ET failures. Nevertheless, the incidence of ectopic pregnancy, multiple pregnancy, and miscarriages were not significantly different between the case and control groups.ConclusionFor women who are undergoing IVF-ET and have experienced repeated embryo implantation failure, atosiban may be an important factor in enhancing pregnancy outcomes. To confirm this conclusion, more thorough, prospective randomized controlled studies of sizable sample sizes with well design are required.

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“…12 The latest RCT conducted by Buddhabunyakan et al did not show a statistically significant difference in uterine peristalsis and pregnancy rates between atosiban and placebo in the overall population. 13 Excessive endometrial peristalsis in the frozen-thawed embryo transfer (FET) cycle was detected by a cohort study in women with recurrent implantation failure. 14 Given the potential effect on uterine relaxation, using atosiban for cryopreserved ET may be of greater benefit to those patients for whom IVF failed in the past without a known cause.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…The study conducted by Ng et al failed to demonstrate any therapeutic advantages associated with the administration of atosiban in patients undergoing IVF, irrespective of history of IVF failure 12. The latest RCT conducted by Buddhabunyakan et al did not show a statistically significant difference in uterine peristalsis and pregnancy rates between atosiban and placebo in the overall population 13…”

Section: Introductionmentioning

confidence: 98%

Effectiveness of atosiban in women with previous single implantation failure undergoing frozen-thawed blastocyst transfer: study protocol for a randomised controlled trial

Cai,

Liu,

Chen

et al. 2023

BMJ Open

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BackgroundUterine contractions may interfere with embryo implantation in assisted reproductive technology. To reduce these contractions and improve success rates, the oxytocin antagonist atosiban has been suggested for administration during embryo transfer. The aim of this study is to evaluate the effectiveness of atosiban in increasing live birth rates among women who have previously experienced a single implantation failure and are scheduled for single blastocyst transfer.Methods and analysisWe conduct a single-centre randomised controlled study comparing atosiban and placebo in women undergoing a single blastocyst transfer with a previous failed blastocyst transfer. Women with endocrine or systemic illnesses, recurrent miscarriages, uterine malformations or fibroids, untreated hydrosalpinx, endometriosis (stage III or IV) or uterine fibroids, as well as women undergoing preimplantation genetic testing, are ineligible. The primary outcome is live birth resulting from the frozen-thawed embryo transfer. Secondary outcomes include biochemical/clinical pregnancy, miscarriage, ectopic pregnancy, multiple pregnancies as well as maternal and perinatal outcomes. We plan to recruit 1100 women (550 women per group). This will allow us to demonstrate or refute an increase in live birth rate from 40% to 50%. Data analysis will follow the intention-to-treat principle. We will measure patterns of uterine peristalsis which will allow subgroup analysis for women with or without uterine peristalsis.Ethics and disseminationThis study has been approved by the Institutional Review Board of Northwest Women’s and Children’s Hospital (No. SZ2019001). Written informed consent will be obtained from each participant before randomisation. The results of the trial will be presented at scientific meetings and reported in publications.Trial registration numberChiCTR1900022333.

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Effects of atosiban on uterine peristalsis following frozen embryo transfer: A randomized controlled trial

Cited by 13 publications

References 26 publications

An Endometrial Thickness < 8 mm Was Associated With a Significantly Increased Risk of EP After Freeze-Thaw Transfer: An Analysis of 5,960 Pregnancy Cycles

An Endometrial Thickness < 8 mm Was Associated With a Significantly Increased Risk of EP After Freeze-Thaw Transfer: An Analysis of 5,960 Pregnancy Cycles

Efficacy of atosiban for repeated embryo implantation failure: A systematic review and meta-analysis

Effectiveness of atosiban in women with previous single implantation failure undergoing frozen-thawed blastocyst transfer: study protocol for a randomised controlled trial

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