Dieamant Felipe, Petersen Claudia G, Mauri Ana L, Comar Vanessa, Mattila Marina, Vagnini Laura D, Renzi Adriana, Petersen Bruna, Ricci Juliana, Oliveira João Batista A, Baruffi Ricardo L R, Franco Jose G
Center for Human Reproduction Prof. Franco Jr, Ribeirão Preto, Brazil.
Paulista Center for Diagnosis Research and Training, Ribeirão Preto, Brazil.
JBRA Assist Reprod. 2017 Sep 1;21(3):240-246. doi: 10.5935/1518-0557.20170045.
This study aimed to evaluate if single medium is better than sequential medium at improving ongoing pregnancy rates in patients undergoing assisted reproductive technology (ART) procedures. The data featured in this meta-analysis were extracted from four randomized controlled trials yielded from a systematic search carried out on electronic databases. The primary endpoint was ongoing pregnancy rate. Secondary endpoints included clinical pregnancy and miscarriage rates. The endpoints for ongoing pregnancy rate were also analyzed based on the time at which the embryo transfers were performed: cleavage stage (day 2/3) and/or blastocyst stage (day 5/6). There were no significant differences between single and sequential medium for clinical pregnancy (RR=1.09; 95%CI=0.83-1.44; p=0.53), ongoing pregnancy (RR=1.11; 95%CI=0.87-1.40; p=0.39), or miscarriage rates (RR=0.89; 95%CI=0.44-1.81; p=0.74). No significant difference was found for ongoing pregnancy rate (RR=1.29; 95%CI=0.93-1.78; p=0.12) between single and sequential medium when only trials in which embryos were transferred at the blastocyst stage were included. In conclusion, the choice of embryo culture approach - single or sequential medium - did not affect the ongoing pregnancy rates of patients undergoing ART cycles.
本研究旨在评估在辅助生殖技术（ART）程序中，单一培养基在提高持续妊娠率方面是否优于序贯培养基。本荟萃分析中的数据来自对电子数据库进行系统检索得到的四项随机对照试验。主要终点是持续妊娠率。次要终点包括临床妊娠率和流产率。还根据胚胎移植的时间分析持续妊娠率的终点：卵裂期（第2/3天）和/或囊胚期（第5/6天）。在临床妊娠（RR = 1.09；95%CI = 0.83 - 1.44；p = 0.53）、持续妊娠（RR = 1.11；95%CI = 0.87 - 1.40；p = 0.39）或流产率（RR = 0.89；95%CI = 0.44 - 1.81；p = 0.74）方面，单一培养基和序贯培养基之间没有显著差异。当仅纳入在囊胚期进行胚胎移植的试验时，单一培养基和序贯培养基在持续妊娠率方面没有显著差异（RR = 1.29；95%CI = 0.93 - 1.78；p = 0.12）。总之，胚胎培养方法的选择——单一培养基或序贯培养基——不会影响接受ART周期患者的持续妊娠率。
