Neonatal Outcomes of Single Delivery after Embryo Transfer at Blastocyst and Cleavage Stages in Fresh Cycles: A Meta-Analysis

doi:10.12280/gjszjk.20200741

Abstract

Abstract:

Objective: To evaluate systematically the neonatal outcomes of single delivery after embryo transfer at blastocyst and cleavage stages in the fresh cycles. Methods: A systematic search was performed on PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, Wanfang and VIP databases (up to November 2020) to search the related studies on the neonatal outcomes of single birth after blastocyst and cleavage stage fresh embryo transfer. The evaluators screened the literature, evaluated the quality and extracted the data according to the inclusion and exclusion criteria. The RevMan 5.3 software was used for data analysis. Results: Thirteen studies were scrutinized for this meta-analysis. The overall showed that the incidences of very preterm birth (VPTB, RR=1.17, 95%CI: 1.08-1.26, P<0.000 1) and large for gestational age (LGA, RR=1.11, 95%CI: 1.04-1.19, P=0.002) were significantly increased, and the incidence of small for gestational age (SGA, RR=0.85, 95%CI: 0.78-0.93, P=0.000 6) was significantly decreased, in the single delivery after the blastocyst embryo transfer when compared with the embryo transfer at cleavage stage. There were no significant differences in the incidences of preterm birth (PTB, RR=1.10, 95%CI: 0.98-1.22, P=0.09), low birth weight (LBW, RR=1.00, 95%CI: 0.94-1.07, P=0.90) and very low birth weight (VLBW, RR=0.99, 95%CI: 0.89-1.10, P=0.88). Subgroup analysis showed that the incidence of neonatal PTB in the blastocyst group was significantly higher than that in the cleavage-embryo group (RR=1.28, 95%CI: 1.23-1.33, P<0.000 01). Conclusions: In the neonatal outcomes of single delivery in the fresh cycles, blastocyst transfer has the higher risks of VPTB and LGA and lower risk of SGA when compared with cleavage embryo transfer.

Key words: Cleavage stage, ovum, Blastula, Embryo transfer, Neonatal outcomes, Meta-analysis

ZHANG Hui, CHAI Liang-ting, LU Jing, WANG Chang-yan, CHANG Wen-liang. Neonatal Outcomes of Single Delivery after Embryo Transfer at Blastocyst and Cleavage Stages in Fresh Cycles: A Meta-Analysis[J]. Journal of International Reproductive Health/Family Planning, 2021, 40(5): 359-365.

Figures/Tables 9

References 28

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研究文献	国家	统计时间	数据来源	研究类型	受精方式	移植时间	结局指标	NOS评分
Dar 2013^[11]	加拿大	2001—2009	多中心	队列研究	IVF/ICSI	day3 vs. day5/6	①~④	9
De Vos 2015^[12]	比利时	2004.04—2009.12	单中心	队列研究	IVF/ICSI	day3 vs. day5	①~④	8
De Vos 2018^[13]	比利时	2010.09—2015.08	单中心	队列研究	IVF/ICSI	day 3 vs. day 5	①~④	8
Ishihara 2014^[14]	日本	2008—2010	多中心	队列研究	IVF/ICSI	未提及	①~⑥	8
Kalra 2012^[15]	美国	2004—2006	多中心	队列研究	IVF	day 3 vs. day5/6	①~③	8
Marconi 2019^[16]	英国	1999—2011	多中心	队列研究	IVF/ICSI	未提及	①~④	8
Maxwell 2015^[17]	美国	2003—2012	单中心	队列研究	IVF/ICSI	day 2/3 vs. day 5	①~②	8
Oron 2014^[18]	加拿大	2008.12—2012.12	单中心	队列研究	IVF/ICSI	day 2/3 vs. day 5	①~⑥	8
Pereira 2016^[19]	美国	2004—2013	单中心	队列研究	IVF	day 3 vs. day 5	①③④	7
Shi 2019^[20]	中国	2006.01—2015.12	单中心	队列研究	IVF/ICSI	day 2/3 vs. day 5	①~④	7
Spangmose 2020^[21]	丹麦、挪威、瑞典	1997—2015	多中心	队列研究	IVF/ICSI	未提及	①~⑥	9
Zhu 2014^[22]	中国	2009.01—2012.06	单中心	队列研究	IVF/ICSI	day 3 vs. day 5/6	⑤⑥	8
刘文霞2019^[23]	中国	2014.01—2016.06	单中心	队列研究	IVF/ICSI	day 3 vs. day 5	①~⑥	7

研究文献	国家	统计时间	数据来源	研究类型	受精方式	移植时间	结局指标	NOS评分
Dar 2013^[11]	加拿大	2001—2009	多中心	队列研究	IVF/ICSI	day3 vs. day5/6	①~④	9
De Vos 2015^[12]	比利时	2004.04—2009.12	单中心	队列研究	IVF/ICSI	day3 vs. day5	①~④	8
De Vos 2018^[13]	比利时	2010.09—2015.08	单中心	队列研究	IVF/ICSI	day 3 vs. day 5	①~④	8
Ishihara 2014^[14]	日本	2008—2010	多中心	队列研究	IVF/ICSI	未提及	①~⑥	8
Kalra 2012^[15]	美国	2004—2006	多中心	队列研究	IVF	day 3 vs. day5/6	①~③	8
Marconi 2019^[16]	英国	1999—2011	多中心	队列研究	IVF/ICSI	未提及	①~④	8
Maxwell 2015^[17]	美国	2003—2012	单中心	队列研究	IVF/ICSI	day 2/3 vs. day 5	①~②	8
Oron 2014^[18]	加拿大	2008.12—2012.12	单中心	队列研究	IVF/ICSI	day 2/3 vs. day 5	①~⑥	8
Pereira 2016^[19]	美国	2004—2013	单中心	队列研究	IVF	day 3 vs. day 5	①③④	7
Shi 2019^[20]	中国	2006.01—2015.12	单中心	队列研究	IVF/ICSI	day 2/3 vs. day 5	①~④	7
Spangmose 2020^[21]	丹麦、挪威、瑞典	1997—2015	多中心	队列研究	IVF/ICSI	未提及	①~⑥	9
Zhu 2014^[22]	中国	2009.01—2012.06	单中心	队列研究	IVF/ICSI	day 3 vs. day 5/6	⑤⑥	8
刘文霞2019^[23]	中国	2014.01—2016.06	单中心	队列研究	IVF/ICSI	day 3 vs. day 5	①~⑥	7