Day three versus day two embryo transfer following in vitro fertilization or intracytoplasmic sperm injection
- 19 April 2004
- reference entry
- research article
- Published by Wiley
- No. 2,p. CD004378
- https://doi.org/10.1002/14651858.cd004378.pub2
Abstract
Background Embryo transfer (ET) was traditionally performed two days after oocyte retrieval; however, developments in culture media have allowed embryos to be maintained in culture for longer periods. Delaying transfer from day two to day three would allow for further development of the embryo and might have a positive effect on pregnancy outcomes. Objectives To determine if there is any difference in live birth and pregnancy rates when ET is performed on day three, compared with day two, in infertile couples undergoing treatment with in vitro fertilization (IVF), including intracytoplasmic sperm injection (ICSI). Search methods We searched the Cochrane Menstrual Disorders & Subfertility Group trials register (17th December 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2003), MEDLINE (1966 to 2003), EMBASE (1980 to 2003) and Biological Abstracts Databases (1980 to 2003), the National Research Register (NRR), the Medical Research Council's Clinical Trials Register, the NHS Centre for Reviews and Dissemination, citation lists of relevant publications, review articles and included studies, as well as abstracts of appropriate scientific meetings. Selection criteria Randomized controlled trials that compared day three versus day two embryo transfer after oocyte retrieval during an IVF or ICSI treatment cycle in subfertile couples. Data collection and analysis Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. The primary outcome measures were live birth rate and ongoing pregnancy rate. Main results Ten studies involving 2027 women were included, but only three studies reported live birth and four reported ongoing pregnancy rates. The pooled odds ratios (day three compared to day two) were 1.07, 95% CI 0.84 to 1.37 for live birth and 1.05, 95% CI 0.83 to 1.32 for ongoing pregnancy. From ten studies, the pooled odds ratio for clinical pregnancy was 1.26, 95% CI 1.06 to 1.51. Sub‐group analysis revealed that this advantage occurred in those undergoing ICSI cycles. A higher miscarriage rate with day 3 ET in ICSI cycles works to negate the increased clinical pregnancy rate, in agreement with the finding of no significant difference between treatments in live birth rate. Authors' conclusions Although an increase in clinical pregnancy rate with day three embryo transfer was demonstrated, at present there is not sufficient good quality evidence to suggest an improvement in live birth when embryo transfer is delayed from day two to day three.Keywords
This publication has 23 references indexed in Scilit:
- Cleavage stage versus blastocyst stage embryo transfer in assisted conceptionPublished by Wiley ,2005
- Pronuclear embryo transfer on day 1 versus cleavage stage embryo transfer on day 3: a prospective randomized trialFertility and Sterility, 2002
- High outcome predictability after IVF using a combined score for zygote and embryo morphology and growth rateHuman Reproduction, 2002
- Management of infertilityBMJ, 2002
- Optimal information sizeEvidence-based Obstetrics & Gynecology, 2002
- Improving IVF outcome in consecutive attempts by selecting embryos on day three transfer.Fertility and Sterility, 2001
- Endometrial Receptivity: Changes in Cell-Surface MorphologySeminars in Reproductive Medicine, 2000
- Day 2 vs. Day 3 Embryo Transfer: Is It the Same?Fertility and Sterility, 2000
- Profiling Assisted Reproductive Technology: Outcomes and Quality of Infertility ManagementFertility and Sterility, 1998
- Improved clinical outcomes for in vitro fertilization with delay of embryo transfer from 48 to 72 hours after oocyte retrieval: use of glucose- and phosphate-free mediaFertility and Sterility, 1998