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Can Comprehensive Chromosome Screening Technology Improve IVF/ICSI Outcomes? A Meta-Analysis.

Chen M, Wei S, Hu J, Quan S - PLoS ONE (2015)

Bottom Line: A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24).The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Reproductive Centre, Nanfang Hospital, Southern Medical University, Guangzhou, China.

ABSTRACT

Objective: To examine whether comprehensive chromosome screening (CCS) for preimplantation genetic screening (PGS) has an effect on improving in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes compared to traditional morphological methods.

Methods: A literature search was conducted in PubMed, EMBASE, CNKI and ClinicalTrials.gov up to May 2015. Two reviewers independently evaluated titles and abstracts, extracted data and assessed quality. We included studies that compared the IVF/ICSI outcomes of CCS-based embryo selection with those of the traditional morphological method. Relative risk (RR) values with corresponding 95% confidence intervals (CIs) were calculated in RevMan 5.3, and subgroup analysis and Begg's test were used to assess heterogeneity and potential publication bias, respectively.

Results: Four RCTs and seven cohort studies were included. A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24). CCS-based PGS was also related to an increased clinical pregnancy rate (RCT RR 1.26, 95% CI 0.83-1.93; cohort study RR 1.48, 95% CI 1.20-1.83), an increased ongoing pregnancy rate (RCT RR 1.31, 95% CI 0.64-2.66; cohort study RR 1.61, 95% CI 1.30-2.00), and an increased live birth rate (RCT RR 1.26, 95% CI 1.05-1.50; cohort study RR 1.35, 95% CI 0.85-2.13) as well as a decreased miscarriage rate (RCT RR 0.53, 95% CI 0.24-1.15; cohort study RR 0.31, 95% CI 0.21-0.46) and a decreased multiple pregnancy rate (RCT RR 0.02, 95% CI 0.00-0.26; cohort study RR 0.19, 95% CI 0.07-0.51). The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.

Conclusions: The effectiveness of CCS-based PGS is comparable to that of traditional morphological methods, with better outcomes for women receiving IVF/ICSI technology. The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

No MeSH data available.


Related in: MedlinePlus

Flow chart of search and selection strategy.
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pone.0140779.g001: Flow chart of search and selection strategy.

Mentions: A total of 1235 unduplicated titles and abstracts were identified in the initial search, and 23 articles were selected to undergo full-text assessment. Twelve studies did not fulfill the inclusion criteria, of these, five studies had no suitable control group, one study included chromosome abnornal patients, one study used clinical outcome data reported previously in another study we included in our meta-analysis, one study did not report implantation rate, four studies associated with polar body biopsy. Finally, 4 RCTs and 7 cohort studies that assessed the outcomes of CCS-based PGS versus traditional morphological-based selection in women undergoing IVF/ICSI met our inclusion criteria and were included in the meta-analysis [29–39]. A flow chart of the trials included in the meta-analysis is shown in Fig 1.


Can Comprehensive Chromosome Screening Technology Improve IVF/ICSI Outcomes? A Meta-Analysis.

Chen M, Wei S, Hu J, Quan S - PLoS ONE (2015)

Flow chart of search and selection strategy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4607161&req=5

pone.0140779.g001: Flow chart of search and selection strategy.
Mentions: A total of 1235 unduplicated titles and abstracts were identified in the initial search, and 23 articles were selected to undergo full-text assessment. Twelve studies did not fulfill the inclusion criteria, of these, five studies had no suitable control group, one study included chromosome abnornal patients, one study used clinical outcome data reported previously in another study we included in our meta-analysis, one study did not report implantation rate, four studies associated with polar body biopsy. Finally, 4 RCTs and 7 cohort studies that assessed the outcomes of CCS-based PGS versus traditional morphological-based selection in women undergoing IVF/ICSI met our inclusion criteria and were included in the meta-analysis [29–39]. A flow chart of the trials included in the meta-analysis is shown in Fig 1.

Bottom Line: A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24).The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Reproductive Centre, Nanfang Hospital, Southern Medical University, Guangzhou, China.

ABSTRACT

Objective: To examine whether comprehensive chromosome screening (CCS) for preimplantation genetic screening (PGS) has an effect on improving in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes compared to traditional morphological methods.

Methods: A literature search was conducted in PubMed, EMBASE, CNKI and ClinicalTrials.gov up to May 2015. Two reviewers independently evaluated titles and abstracts, extracted data and assessed quality. We included studies that compared the IVF/ICSI outcomes of CCS-based embryo selection with those of the traditional morphological method. Relative risk (RR) values with corresponding 95% confidence intervals (CIs) were calculated in RevMan 5.3, and subgroup analysis and Begg's test were used to assess heterogeneity and potential publication bias, respectively.

Results: Four RCTs and seven cohort studies were included. A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24). CCS-based PGS was also related to an increased clinical pregnancy rate (RCT RR 1.26, 95% CI 0.83-1.93; cohort study RR 1.48, 95% CI 1.20-1.83), an increased ongoing pregnancy rate (RCT RR 1.31, 95% CI 0.64-2.66; cohort study RR 1.61, 95% CI 1.30-2.00), and an increased live birth rate (RCT RR 1.26, 95% CI 1.05-1.50; cohort study RR 1.35, 95% CI 0.85-2.13) as well as a decreased miscarriage rate (RCT RR 0.53, 95% CI 0.24-1.15; cohort study RR 0.31, 95% CI 0.21-0.46) and a decreased multiple pregnancy rate (RCT RR 0.02, 95% CI 0.00-0.26; cohort study RR 0.19, 95% CI 0.07-0.51). The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.

Conclusions: The effectiveness of CCS-based PGS is comparable to that of traditional morphological methods, with better outcomes for women receiving IVF/ICSI technology. The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

No MeSH data available.


Related in: MedlinePlus