Ectopic pregnancy rates in day 3 versus day 5 embryo transfers in fresh IVF cycles

Kathiresan, A.S.Q.; Rodriguez, M.; Wang, E.; Pisarska, Margareta D.; Hill, David L.; Alexander, Carolyn

doi:10.1016/j.fertnstert.2013.07.210

Cited by 2 publications

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“…Characters of the 23 eligible studies were listed in Fig 2 , of which two were conference reports [ 21 , 22 ], seven were RCTs[ 23 – 29 ], and sixteen were retrospective studies[twelve cohort [ 8 , 10 – 14 , 21 , 30 – 33 ] and 4 case-control studies[ 9 , 22 , 34 , 35 ]] ( Fig 2 ). Thirty-three studies were conducted in combined IVF/ICSI cycles[ 8 , 11 , 13 , 23 – 28 , 31 , 33 , 34 ],9 studies were in IVF [ 9 , 10 , 12 , 14 , 21 , 22 , 29 , 30 , 32 ]and one study were only in ICSI cycles[ 35 ]. All studies compared the EP rate between day 3 versus day 5 except two[ 34 , 35 ], which compared day2/3 versus day 5/6.Embryos transferred on day2/3 were grouped to D3-ET group and embryos transferred on day5/6 were grouped to D5-ET group.…”

Section: Resultsmentioning

confidence: 99%

Reduced Ectopic Pregnancy Rate on Day 5 Embryo Transfer Compared with Day 3: A Meta-Analysis

et al. 2017

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ObjectiveTo compare the risk of ectopic pregnancy (EP) after embryo transfer on day 3(D3-ET) and day 5(D5-ET).DesignMeta-analysisPatientsWomen with pregnancy resulting from in vitro undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI)Result(s)Twenty-two studies were identified through research conducted using the PubMed, Embase, and Cochrane databases and ClinicalTrials.gov. All studies were conducted prior to October 2016. Adding the reproductive data from our center, a total of 143 643 pregnancies were reviewed(D3-ET: n = 62027,D5-ET:n = 81616). A lower EP rate was found in women undergoing D5-ET than in those undergoing D3-ET [relative risk (RR), 0.67;95% confidence interval (CI), 0.54–0.85;143643 pregnancies in 23 studies; I2 = 67%]. These results were validated in subgroups of fresh embryo-transfer (Fre-ET) cycles [RR, 0.78; 95%CI, 0.69–0.88; 91 871 pregnancies in 21 studies; I2 = 29%] and frozen-thawed embryo-transfer (Fro-ET) cycles [RR, 0.43; 95%CI, 0.36–0.51; 51 772 pregnancies in 10 studies; I2 = 33%]. After separating out the randomized controlled trials (RCTs), a significant difference was found in the retrospective studies in both subgroups [both Fre-ET (RR,0.78;95% CI 0.69–0.88);91182 pregnancies in 14 studies; I2 = 45%] and Fro-ET(RR,0.43;95% CI 0.36–0.51; 51751pregnancies in 9 studies;I2 = 33%)], while the RCTs showed no statistical significance for Fre-ET cycles[RR,0.86;95% CI 0.32–2.26); 689 pregnancies in 7 studies; I2 = 0%].Conclusion(s)The present study indicates that D5-ET reduces the risk for EP in cycles that use IVF or ICSI, compared with D3-ET. It suggests that D5-ET may be a better choice for decreasing the EP rate in assisted reproductive technology. Further high-quality randomized controlled trials are anticipated.

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