Morula transfer as alternative to blastocyst transfer or day 3 transfer

Nada, A. A.; Khalil, Reham F.; Sawaf, Ahmed; Elhalwagy, Ahmed

doi:10.1097/01.ebx.0000458877.10672.6c

Cited by 1 publication

(5 citation statements)

References 18 publications

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“…Thereafter, full texts were screened seeking for ultimately relevant articles, as well as the reference lists of selected relevant publications were assessed for final inclusion. This thorough screening resulted in a total of 15 studies [5,6,8,13,[17][18][19][20][21][22][23][24][25][26][27] that are employed for the present meta-analysis. In Fig.…”

Section: Search Strategymentioning

confidence: 99%

“…Fifteen studies [5,6,8,13,[17][18][19][20][21][22][23][24][25][26][27] reported results on clinical pregnancy rates per ET cycle. Five different study designs (D4 vs. D3; D4 vs. D5; D4 vs. D2/3; D4 vs. D3/5; D4 vs. D2/3/5) comparing a total of four different days including 11,034 ET cycles were evaluated.…”

Section: Clinical Pregnancy Per Etmentioning

confidence: 99%

“…Four studies [13,[22][23][24] reported results on clinical pregnancy per patient. Two different study designs (D4 vs. D3; D4 vs. D3/5) comparing a total of three different days including 3873 ET cycles were evaluated.…”

Section: Clinical Pregnancy Per Patientmentioning

confidence: 99%

“…A sensitivity analysis based on prospective studies was performed, in order to statistically strengthen the validity of the sourced results. Six prospective studies were included [13,17,[22][23][24][25] Supplementary Fig. 6.…”

Section: Sensitivity Analysismentioning

confidence: 99%

“…The rationale behind D4 ET is similar to that of blastocyst transfer, regarding the improved uterine receptivity, in line with reduced contractility, resulting to higher chances of successful implantation [18,23]. The advancement to the morula stage guarantees the switch from maternal to embryonic gene activation, a fact that could represent as an additional advantage [55].…”

Section: Fixed Effect Model Random Effects Modelmentioning

confidence: 99%

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Should the flexibility enabled by performing a day-4 embryo transfer remain as a valid option in the IVF laboratory? A systematic review and network meta-analysis

Simopoulou

Sfakianoudis²,

Tsioulou

et al. 2019

J Assist Reprod Genet

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Purpose The present systematic review and network meta-analysis aims to uniquely bring to literature data supporting the true place of the alternative practice of day-4 embryo transfer (D4 ET) in an IVF laboratory, beyond the one-dimensional option of facilitating a highly demanding program. Methods A systematic search was conducted in the databases of PubMed/Medline, Embase, and Cochrane Central Library, resulting to six prospective along with nine retrospective cohort studies meeting eligibility criteria for inclusion. A comparison of D4 ET with day-2 (D2), day-3 (D3), and day-5 (D5) ET, respectively, was performed employing R statistics. Results The sourced results indicate no statistically significant difference regarding clinical pregnancy rates, and ongoing pregnancy/live birth rates stemming from the comparison of D4 with D2, D4 with D3, and D4 with D5 ET, respectively. Additionally, no statistically significant difference could be established in respect to cancelation, and miscarriage rates, following the comparison of D4 with D3 and D4 with D5 ET. Interestingly, we report statistically significant lower preterm birth rates associated with D4 ET, in contrast with D5 ET (RR, 0.19; 95% CI, 0.05-0.67; p value = 0.01). Conclusions The aforementioned results may serve as advocates buttressing the option of D4 ET as a valid candidate in the ET decision-making process. Possible limitations of the current study are the publication bias stemming from the retrospective nature of certain included studies, along with various deviations among studies' design, referring to number and quality of transferred embryos, or different culture conditions referring to studies of previous decades.

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