Reproductive Medicine, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
Fertil Steril. 2012 Aug;98(2):368-77.e1-9. doi: 10.1016/j.fertnstert.2012.05.019. Epub 2012 Jun 13.
To perform a systematic review and meta-analysis of obstetric and perinatal complications in singleton pregnancies after the transfer of frozen thawed and fresh embryos generated through IVF.
Systematic review.
Observational studies, comparing obstetric and perinatal outcomes in singleton pregnancies subsequent to frozen thawed ET versus fresh embryo transfer, were included from Medline, EMBASE, Cochrane Central Register of Clinical Trials, DARE, and CINAHL (1984-2012).
PATIENT(S): Women undergoing IVF/intracytoplasmic sperm injection (ICSI).
INTERVENTION(S): Two independent reviewers extracted data and assessed the methodological quality of the relevant studies using critical appraisal skills program scoring. Risk ratios and risk differences were calculated in Rev Man 5.1. Subgroup analysis was performed on matched cohort studies.
MAIN OUTCOME MEASURE(S): Antepartum hemorrhage, very preterm birth, preterm birth, small for gestational age, low birth weight, very low birth weight, cesarean section, congenital anomalies, perinatal mortality, and admission to neonatal intensive care unit.
RESULT(S): Eleven studies met the inclusion criteria. Singleton pregnancies after the transfer of frozen thawed embryos were associated with better perinatal outcomes compared with those after fresh IVF embryos. The relative risks (RR) and 95% confidence intervals (CI) of antepartum hemorrhage (RR = 0.67, 95% CI 0.55-0.81), preterm birth (RR = 0.84, 95% CI 0.78-0.90), small for gestational age (RR = 0.45, 95% CI 0.30-0.66), low birth weight (RR = 0.69, 95% CI 0.62-0.76), and perinatal mortality (RR = 0.68, 95% CI 0.48-0.96) were lower in women who received frozen embryos.
CONCLUSION(S): Although fresh ET is the norm in IVF, results of this systematic review of observational studies suggest that pregnancies arising from the transfer of frozen thawed IVF embryos seem to have better obstetric and perinatal outcomes.
系统评价和荟萃分析通过体外受精（IVF）生成的冷冻解冻和新鲜胚胎移植后单胎妊娠的产科和围产期并发症。
系统评价。
纳入了从 Medline、EMBASE、Cochrane 临床对照试验中心注册库、DARE 和 CINAHL（1984-2012）中检索到的比较冷冻解冻胚胎移植后与新鲜胚胎移植后单胎妊娠的产科和围产期结局的观察性研究。
接受 IVF/胞浆内精子注射（ICSI）的女性。
两名独立的审查员使用批判性评价技巧方案评分提取数据并评估相关研究的方法学质量。使用 Rev Man 5.1 计算风险比和风险差异。对匹配队列研究进行亚组分析。
产前出血、极早产、早产、小于胎龄儿、低出生体重儿、极低出生体重儿、剖宫产术、先天畸形、围产儿死亡率和新生儿重症监护病房入院。
11 项研究符合纳入标准。与新鲜 IVF 胚胎相比，冷冻解冻胚胎移植后的单胎妊娠具有更好的围产期结局。产前出血（RR=0.67，95%CI 0.55-0.81）、早产（RR=0.84，95%CI 0.78-0.90）、小于胎龄儿（RR=0.45，95%CI 0.30-0.66）、低出生体重儿（RR=0.69，95%CI 0.62-0.76）和围产儿死亡率（RR=0.68，95%CI 0.48-0.96）的相对风险（RR）和 95%置信区间（CI）较低。
尽管新鲜胚胎移植是 IVF 的常规方法，但这项对观察性研究的系统评价结果表明，来自冷冻解冻 IVF 胚胎移植的妊娠似乎具有更好的产科和围产期结局。
