Sordia-Hernandez Luis H, Morales Martinez Felipe A, Orozco Eduardo Gutierrez, Flores-Rodriguez Andrea, Leyva-Camacho Paloma C, Alvarez-Villalobos Neri Alejandro, Zuñiga-Hernandez Jorge Alberto
Department of Gynecology and Obstetrics, University Hospital Dr. Jose Eleuterio González Universidad Autónoma de Nuevo León, Monterrey, México.
Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
J Reprod Infertil. 2021 Apr-Jun;22(2):77-84. doi: 10.18502/jri.v22i2.5792.
The purpose of this study was to evaluate the effect of post warming culture period between thawing and transfer of cryopreserved embryos on reproductive outcomes after in vitro fertilization (IVF).
An extensive literature search was performed using PubMed, EmBase, and the Cochrane library from January 2000 to August 2019. A systematic review and meta-analysis of clinical trials was performed in this manuscript. The trials represented patients with embryo transfers of at least one previously cryopreserved good quality embryo. Main outcome measures of the study included clinical pregnancy rate, live birth rate, miscarriage rate, and ectopic pregnancy rate.
A total of 5338 trial/abstracts were identified through a literature search. Totally, five studies were included in the systematic review, and three in the final meta-analysis. The studies included 1717 embryo transfers, 605 after short culture, and 1112 after long culture. The clinical pregnancy rate (CPR) was the most consistent outcome reported. The CPR was slightly better after short time culture with a RR of 1.09 (0.95-1.26, 95%CI) but this difference was not statistically significant. The great heterogenicity in the results reported in the included studies made it impossible to compare all planned outcomes.
There are no differences in reproductive outcomes if cryopreserved embryos are transferred after overnight culture or after two hours of culture following thawing. Due to small number and the poor quality of trials reported on this topic, the results of this review should be treated with caution.
本研究旨在评估冷冻胚胎解冻与移植之间的复温培养时间对体外受精（IVF）后生殖结局的影响。
使用PubMed、EmBase和Cochrane图书馆对2000年1月至2019年8月的文献进行了广泛检索。本研究对临床试验进行了系统评价和荟萃分析。这些试验纳入了至少移植一枚先前冷冻的优质胚胎的患者。本研究的主要结局指标包括临床妊娠率、活产率、流产率和异位妊娠率。
通过文献检索共识别出5338项试验/摘要。总共5项研究纳入系统评价，3项纳入最终荟萃分析。这些研究包括1717例胚胎移植，其中短期培养后移植605例，长期培养后移植1112例。临床妊娠率（CPR）是报道中最一致的结局。短期培养后的CPR略好，相对危险度为1.09（0.95 - 1.26，95%可信区间），但差异无统计学意义。纳入研究报告结果的高度异质性使得无法比较所有计划的结局。
冷冻胚胎解冻后过夜培养或培养两小时后移植，生殖结局无差异。由于关于该主题的试验数量少且质量差，本综述结果应谨慎对待。
