Raluca Tocariu, Lucia Elena Niculae, Alexandru Ștefan Niculae, Andreea Carp-Velișcu, Elvira Brătilă
{"title":"体外受精/卵胞浆内单精子注射周期中新鲜胚胎移植与冷冻胚胎移植的比较:新生儿结局的系统回顾和元分析》。","authors":"Raluca Tocariu, Lucia Elena Niculae, Alexandru Ștefan Niculae, Andreea Carp-Velișcu, Elvira Brătilă","doi":"10.3390/medicina60081373","DOIUrl":null,"url":null,"abstract":"<p><p><i>Background and Objectives</i>: Although considerable research has been devoted to examining the distinctions between fresh and frozen embryo transfer regarding obstetric outcomes and rates of pregnancy success, there is still a scarcity of thorough analyses that specifically examine neonatal outcomes. The objective of our study was to provide an in-depth analysis of neonatal outcomes that occur after the transfer of fresh and frozen embryos (ET vs. FET) in IVF/ICSI cycles. <i>Materials and Methods</i>: Multiple databases (PubMed/MEDLINE, Cochrane Library, Web of Science, Wiley, Scopus, Ovid and Science Direct) were searched from January 1980 to February 2024. Two reviewers conducted the article identification and data extraction, meeting inclusion and exclusion criteria. The methodological quality was evaluated using the Newcastle-Ottawa Scale (NOS) or the revised Cochrane Risk of Bias Tool. The meta-analysis was performed using RevMan 5.4. <i>Results</i>: Twenty studies, including 171,481 participants in total, were subjected to qualitative and quantitative analyses. A significant increase in preterm birth rates was noted with fresh embryo transfer compared to FET in the overall IVF/ICSI population (OR 1.26, 95% CI 1.18-1.35, <i>p</i> < 0.00001), as well as greater odds of a low birth weight (OR 1.37, 95% CI 1.27-1.48, <i>p</i> < 0.00001) and small-for-gestational-age infants in this group (OR 1.81, 95% CI 1.63-2.00, <i>p</i> < 0.00001). In contrast, frozen embryo transfer can result in macrosomic (OR 0.59, 95% CI 0.54-0.65, <i>p</i> < 0.00001) or large-for-gestational-age infants (OR 0.64, 95% CI 0.60-0.69, <i>p</i> < 0.00001). No significant difference was observed regarding congenital malformations or neonatal death rates. <i>Conclusions</i>: This systematic review confirmed that singleton babies conceived by frozen embryo transfer are at lower risk of preterm delivery, low birthweight and being small for gestational age than their counterparts conceived by fresh embryo transfer. The data support embryo cryopreservation but suggest that elective freezing should be limited to cases with a proven indication or within the framework of a clinical study.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356234/pdf/","citationCount":"0","resultStr":"{\"title\":\"Fresh versus Frozen Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: A Systematic Review and Meta-Analysis of Neonatal Outcomes.\",\"authors\":\"Raluca Tocariu, Lucia Elena Niculae, Alexandru Ștefan Niculae, Andreea Carp-Velișcu, Elvira Brătilă\",\"doi\":\"10.3390/medicina60081373\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><i>Background and Objectives</i>: Although considerable research has been devoted to examining the distinctions between fresh and frozen embryo transfer regarding obstetric outcomes and rates of pregnancy success, there is still a scarcity of thorough analyses that specifically examine neonatal outcomes. The objective of our study was to provide an in-depth analysis of neonatal outcomes that occur after the transfer of fresh and frozen embryos (ET vs. FET) in IVF/ICSI cycles. <i>Materials and Methods</i>: Multiple databases (PubMed/MEDLINE, Cochrane Library, Web of Science, Wiley, Scopus, Ovid and Science Direct) were searched from January 1980 to February 2024. Two reviewers conducted the article identification and data extraction, meeting inclusion and exclusion criteria. The methodological quality was evaluated using the Newcastle-Ottawa Scale (NOS) or the revised Cochrane Risk of Bias Tool. The meta-analysis was performed using RevMan 5.4. <i>Results</i>: Twenty studies, including 171,481 participants in total, were subjected to qualitative and quantitative analyses. A significant increase in preterm birth rates was noted with fresh embryo transfer compared to FET in the overall IVF/ICSI population (OR 1.26, 95% CI 1.18-1.35, <i>p</i> < 0.00001), as well as greater odds of a low birth weight (OR 1.37, 95% CI 1.27-1.48, <i>p</i> < 0.00001) and small-for-gestational-age infants in this group (OR 1.81, 95% CI 1.63-2.00, <i>p</i> < 0.00001). In contrast, frozen embryo transfer can result in macrosomic (OR 0.59, 95% CI 0.54-0.65, <i>p</i> < 0.00001) or large-for-gestational-age infants (OR 0.64, 95% CI 0.60-0.69, <i>p</i> < 0.00001). No significant difference was observed regarding congenital malformations or neonatal death rates. <i>Conclusions</i>: This systematic review confirmed that singleton babies conceived by frozen embryo transfer are at lower risk of preterm delivery, low birthweight and being small for gestational age than their counterparts conceived by fresh embryo transfer. 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引用次数: 0
摘要
背景和目的:尽管已有大量研究致力于探讨新鲜胚胎移植和冷冻胚胎移植在产科结果和妊娠成功率方面的区别,但专门研究新生儿结果的全面分析仍然很少。我们的研究旨在深入分析试管婴儿/卵胞浆内单精子显微注射(IVF/ICSI)周期中移植新鲜胚胎和冷冻胚胎(ET 与 FET)后的新生儿结局。材料与方法:检索了 1980 年 1 月至 2024 年 2 月期间的多个数据库(PubMed/MEDLINE、Cochrane Library、Web of Science、Wiley、Scopus、Ovid 和 Science Direct)。两名审稿人根据纳入和排除标准对文章进行了识别和数据提取。方法学质量采用纽卡斯尔-渥太华量表(NOS)或修订版 Cochrane 偏倚风险工具进行评估。荟萃分析使用 RevMan 5.4 进行。结果对 20 项研究进行了定性和定量分析,共有 171 481 人参与。在整个试管婴儿/ICSI人群中,新鲜胚胎移植比冷冻胚胎移植的早产率明显增加(OR 1.26,95% CI 1.18-1.35,p < 0.00001),而且这组人群中出现低出生体重儿(OR 1.37,95% CI 1.27-1.48,p < 0.00001)和小胎龄儿(OR 1.81,95% CI 1.63-2.00,p < 0.00001)的几率更大。与此相反,冷冻胚胎移植可导致巨大儿(OR 0.59,95% CI 0.54-0.65,p < 0.00001)或大胎龄儿(OR 0.64,95% CI 0.60-0.69,p < 0.00001)。在先天性畸形或新生儿死亡率方面没有观察到明显差异。结论该系统性综述证实,通过冷冻胚胎移植受孕的单胎婴儿与通过新鲜胚胎移植受孕的单胎婴儿相比,早产、低出生体重和胎龄偏小的风险较低。数据支持胚胎冷冻保存,但建议选择性冷冻应仅限于有明确适应症或在临床研究框架内的病例。
Fresh versus Frozen Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: A Systematic Review and Meta-Analysis of Neonatal Outcomes.
Background and Objectives: Although considerable research has been devoted to examining the distinctions between fresh and frozen embryo transfer regarding obstetric outcomes and rates of pregnancy success, there is still a scarcity of thorough analyses that specifically examine neonatal outcomes. The objective of our study was to provide an in-depth analysis of neonatal outcomes that occur after the transfer of fresh and frozen embryos (ET vs. FET) in IVF/ICSI cycles. Materials and Methods: Multiple databases (PubMed/MEDLINE, Cochrane Library, Web of Science, Wiley, Scopus, Ovid and Science Direct) were searched from January 1980 to February 2024. Two reviewers conducted the article identification and data extraction, meeting inclusion and exclusion criteria. The methodological quality was evaluated using the Newcastle-Ottawa Scale (NOS) or the revised Cochrane Risk of Bias Tool. The meta-analysis was performed using RevMan 5.4. Results: Twenty studies, including 171,481 participants in total, were subjected to qualitative and quantitative analyses. A significant increase in preterm birth rates was noted with fresh embryo transfer compared to FET in the overall IVF/ICSI population (OR 1.26, 95% CI 1.18-1.35, p < 0.00001), as well as greater odds of a low birth weight (OR 1.37, 95% CI 1.27-1.48, p < 0.00001) and small-for-gestational-age infants in this group (OR 1.81, 95% CI 1.63-2.00, p < 0.00001). In contrast, frozen embryo transfer can result in macrosomic (OR 0.59, 95% CI 0.54-0.65, p < 0.00001) or large-for-gestational-age infants (OR 0.64, 95% CI 0.60-0.69, p < 0.00001). No significant difference was observed regarding congenital malformations or neonatal death rates. Conclusions: This systematic review confirmed that singleton babies conceived by frozen embryo transfer are at lower risk of preterm delivery, low birthweight and being small for gestational age than their counterparts conceived by fresh embryo transfer. The data support embryo cryopreservation but suggest that elective freezing should be limited to cases with a proven indication or within the framework of a clinical study.
期刊介绍:
The journal’s main focus is on reviews as well as clinical and experimental investigations. The journal aims to advance knowledge related to problems in medicine in developing countries as well as developed economies, to disseminate research on global health, and to promote and foster prevention and treatment of diseases worldwide. MEDICINA publications cater to clinicians, diagnosticians and researchers, and serve as a forum to discuss the current status of health-related matters and their impact on a global and local scale.