Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis

Papanikolaou, Evangelos; Kolibianakis, Efstratios M.; Tournaye, Herman; Venetis, Christos A.; Fatemi, Human M.; Tarlatzis, Basil C.; Devroey, Paul

doi:10.1093/humrep/dem339

Cited by 268 publications

(138 citation statements)

References 32 publications

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“…In addition, oocyte donors are typically young women with good ovarian reserve, thus embryos should characteristically be healthy with good implantation potential. Recent studies have shown that blastocyst stage embryo transfer is associated with higher implantation and pregnancy rates [27]. The explanation for this finding is twofold.…”

Section: Discussionmentioning

confidence: 99%

Follicular and luteal phase endometrial thickness and echogenic pattern and pregnancy outcome in oocyte donation cycles

Barker

Boehnlein

Kovács

et al. 2009

J Assist Reprod Genet

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Purpose To study the effect of endometrial thickness (ET) and echogenic pattern (EP) in oocyte donation cycles upon pregnancy outcomes. Methods Seventy-nine cycles resulting in blastocyst embryo transfer were evaluated. Donors underwent ovarian hyperstimulation using rFSH and GnRH-antagonist. Recipients were synchronized to donors using GnRH-agonist downregulation followed by fixed dose of estrogen (E2) and progesterone (P4) following hCG. Transvaginal ultrasound (US) obtained ET and EP 10-11 days after initiation of E2 and on day of embryo transfer. Primary outcome was ET and EP in pregnant and non-pregnant cycles. Stimulation and embryology data was analyzed in donors to assess differences prior to transfer.Results Fifty-nine cycles resulted in clinical pregnancy. No differences were observed in pregnant vs. non-pregnant cycles in proliferative or secretory ET and EP. Similar baseline and stimulation characteristics were found in pregnant and non-pregnant cycles. Regression analysis showed end thickness were not predictive of pregnancy outcomes. Conclusions Endometrial characteristics in recipients prior to and following progesterone were not predictive of pregnancy outcomes.

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Section: Discussionmentioning

confidence: 99%

Follicular and luteal phase endometrial thickness and echogenic pattern and pregnancy outcome in oocyte donation cycles

Barker

Boehnlein

Kovács

et al. 2009

J Assist Reprod Genet

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“…A recent meta analysis demonstrated that the probability of live birth following fresh IVF is higher after blastocyst-stage embryo transfer compared to cleavage-stage transfer (Evidence 1a) (Papanikolaou et al, 2008). In the USA, for the year 2005 in women over 40, success rates for day 5 embryo transfers were higher than for day 3 in women over 40.…”

Section: Blastocyst Tranfermentioning

confidence: 99%

What is the role of assisted reproduction technology in the management of age-related infertility?

Marinakis

Nikolaou

2011

Human Fertility

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Although in the UK the upper age limit for National Health Service (NHS) provision of in vitro fertilisation (IVF) is 39 years of age there has been an increase in number of women having fertility treatment in their 40s. However, the success rates of IVF and intra-uterine insemination (IUI) in this group remain low. Human Fertilisation and Embryology Authority (HFEA) data from 2006 showed that the live-birth rate from IVF in the UK was 11% in the age group 40-42, 4.6% in the age group 43-44 and less than 4% in women over 44. We performed a literature search for studies using terms and combinations of terms in online databases and published meta-analyses reporting the outcome of interventions in older women. This review showed that assisted reproduction technologies (ARTs) continue to have low live-birth rates in women over 40. Trials showed that assisted hatching may increase the chance of pregnancy in women with poor history. Blastocyst transfer is associated with better outcome, whereas application of pre-implantation genetic screening (PGS) in older women has not increased the success rates. It appears that, with the exception of egg-donation, ART has no answer yet to age-related decline of female fertility.

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“…In addition, data analysis also supporting the implementation of day 5 embryo transfer as it has better success rates in all age groups including women over 40. But these results do not include the cycles that a day 5 blastocyst failed to develop (CDC 2005;Papanikolaou et al 2008).…”

Section: Discussionmentioning

confidence: 99%

“…Data analysis shows that the implementation of day 5 embryo transfer improves the IVF success rates in all age groups, including women over 40. However, the included studies did not consider the cycles that a blastocyst failed to develop (Papanikolaou et al 2008). Merely reaching the blastocyst stage of embryo development is a good prognostic factor.…”

mentioning

confidence: 99%

National survey of the current management of infertility in women aged 40 and over in the UK

Marinakis

Nikolaou

2012

Journal of Obstetrics and Gynaecology

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We conducted a national survey to identify the variation in the management of infertility in women aged 40 and over among the assisted conception units in the UK. A total of 44 out of 69 IVF units replied by filling in a questionnaire. Nearly half of the units (49%) offer treatment to this age group 6 months after trying for a pregnancy. As first-line management, 71.7% would offer conventional in vitro fertilisation (IVF) and 17.9% intrauterine insemination (IUI). On average, the doctors would move on from IUI to the next step after three attempts. The survey revealed a mean age of 45 as the upper limit for application of IVF (own eggs), and 43% of the units will recommend three cycles of IVF using own eggs before moving to egg donation. Among interventions to improve outcome, 33.3% would consider blastocyst transfer, 5.9% pre-implantation genetic screening (PGS) and 3.9% assisted zona hatching (AZH).

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Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis

Abstract: The best available evidence suggests that the probability of live birth after fresh IVF is significantly higher after blastocyst-stage embryo transfer as compared to cleavage-stage embryo transfer when equal number of embryos are transferred in the two groups compared.

Cited by 268 publications

References 32 publications

Follicular and luteal phase endometrial thickness and echogenic pattern and pregnancy outcome in oocyte donation cycles

Follicular and luteal phase endometrial thickness and echogenic pattern and pregnancy outcome in oocyte donation cycles

What is the role of assisted reproduction technology in the management of age-related infertility?

National survey of the current management of infertility in women aged 40 and over in the UK

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