Lower risk of adverse perinatal outcomes in natural versus artificial frozen-thawed embryo transfer cycles: a systematic review and meta-analysis

REPRODUCTIVE BIOMEDICINE ONLINE

卷:42

Review

Moreno-Sepulveda, Jose^1,2  Jose Espinos, Juan^1,3,4  Angel Checa, Miguel^1,3,5 

[1] Univ Autonoma Barcelona, Obstet & Gynecol Dept, Campus Univ UAB, Bellaterra 08193, Cerdanyola Del, Spain

[2] Clin Mujer Med Reprod, Vina Del Mar 2606, Chile

[3] Fertty Int, Carrer Ausias Marc 25, Barcelona 08010, Spain

[4] Hosp Santa Creu & St, Dept Obstet & Gynaecol, Carrer St Quinti 89, Barcelona 08041, Spain

[5] Inst Hosp del Mar Invest Med, IMIM, Barcelona Infertil Res Grp, GRI BCN, Carrer Dr Aiguader 88, Barcelona 08003, Spain

关键词: Frozen-thawed embryo transfer;    Hypertensive disorders of pregnancy;    Macrosomia;    Natural cycle;    Perinatal outcomes;    Preeclampsia;   

DOI  :  10.1016/j.rbmo.2021.03.002

来源: Elsevier

【 摘 要 】

This systematic review of literature and meta-analysis of observational studies reports on perinatal outcomes after frozen embryo transfer (FET). The aim was to determine whether natural cycle frozen embryo transfer (NC-FET) in singleton pregnancies conceived after IVF decreased the risk of adverse perinatal outcomes compared with artificial cycle frozen embryo transfer (AC-FET). Thirteen cohort studies, including 93,201 cycles, met the inclusion criteria. NC-FET was associated with a lower risk of hypertensive disorders in pregnancy (HDP) (RR 0.61, 95% CI 0.50 to 0.73), preeclampsia (RR 0.47, 95% CI 0.42 to 0.53), large for gestational age (LGA) (RR 0.93, 95% CI 0.90 to 0.96) and macrosomia (RR 0.82, 95% CI 0.69 to 0.97) compared with AC-FET. No significant difference was found in the risk of gestational hypertension and small for gestational age. Secondary outcomes assessed were the risk of preterm birth (RR 0.83, 95% CI 0.79 to 0.88); post-term birth (RR 0.48, 95% CI 0.29 to 0.80); low birth weight (RR 0.84, 95% CI 0.80 to 0.89); caesarean section (RR 0.84, 95% CI 0.77 to 0.91); postpartum haemorrhage (RR 0.39, 95% CI 0.35 to 0.45); placental abruption (RR 0.61, 95% CI 0.38 to 0.98); and placenta accreta (RR 0.18, 95% CI 0.10 to 0.33). All were significantly lower with NC-FET compared with AC-FET. In assessing safety, NC-FET significantly decreased the risk of HDP, preeclampsia, LGA, macrosomia, preterm birth, post-term birth, low birth weight, caesarean section, postpartum haemorrhage, placental abruption and placenta accreta. Further randomized controlled trials addressing the effect of NC-FET and AC-FET on maternal and perinatal outcomes are warranted. Clinicians should carefully monitor pregnancies achieved by FET in artificial cycles prenatally, during labour and postnatally.

【 授权许可】

Free