Effectiveness of Different Embryo Screening Methods before Transplantation: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 YINJian-zhao ¹ , ZHAOJun-da ² , CAIXia ¹

1. The Reproductive Assisted Reproduction Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China;
2. Department of Gynecology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China;

Corresponding author：

Keywords：

Embryo selection; Embryo morphology; NIR; CCS; Pregnancy; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20140041

Video：

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Objective To systematically review the effectiveness of traditional morphological embryo screening method and other screening methods. Methods We electronically searched PubMed, EMbase, Web of Knowledge, CBM, WanFang Data and CNKI, for studies about the effectiveness of traditional morphological embryo screening method and other screening methods from inception to July 1^st, 2013. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed using the software RevMan 5.1. Results A total of 4 studies involving 951 patients were included. The results of meta-analysis showed that, for the traditional morphological embryo screening method, when compared with the NIR method and CCS method, there were no significant differences in clinical pregnancy rate (OR=0.94, 95%CI 0.57 to 1.53, P=0.80) and live birth rate (OR=0.90, 95%CI 0.60 to 1.37, P=0.63). However, significant difference was found for the embryos fragment rate (OR=0.40, 95%CI 0.27 to 0.59, P < 0.000 01). Conclusion The current evidence shows that, compared with other methods, the traditional morphological embryo screening method could significantly reduce the embryos fragments rate. The results are needed to be further validate by more high-quality and large-scale studies.

Citation： YINJian-zhao, ZHAOJun-da, CAIXia. Effectiveness of Different Embryo Screening Methods before Transplantation: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2014, 14(2): 236-240. doi: 10.7507/1672-2531.20140041 Copy

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5.	Vergouw CG, Kieslinger DC, Kostelijk EH, et al. Day 3 embryo selection by metabolomic profiling of culture medium with nearinfrared spectroscopy as an adjunct to morphology:a randomized controlled trial. Hum Reprod, 2012, 27(8):2304-2311.
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9.	Lukassen HG, Braat DD, Wetzels AM, et al. Two cycles with single embryo transfer versus one cycle with double embryo transfer:a randomized controlled trial. Hum Reprod, 2005, 20(3):702-708.
10.	Paternot G, Wetzels AM, Thonon F, et al. Intra-and interobserver analysis in the morphological assessment of early stage embryos during an IVF procedure:a multicentre study. Reprod Biol Endocrinol, 2011, 9:127.
11.	Vergouw CG, Botros LL, Roos P, et al. Metabolomic profiling by near-infrared spectroscopy as a tool to assess embryo viability:a novel, non-invasive method for embryo selection. Hum Reprod, 2008, 23(7):1499-1504.
12.	Seli E, Botros L, Sakkas D, et al. Noninvasive metabolomic profiling of embryo culture media using proton nuclear magnetic resonance correlates with reproductive potential of embryos in women undergoing in vitro fertilization. Fertil Steril, 2008, 90(6):2183-2189.
13.	Forman EJ, Upham KM, Cheng M, et al. Comprehensive chromosome screening alters traditional morphology-based embryo selection:a prospective study of 100 consecutive cycles of planned fresh euploid blastocyst transfer. Fertil Steril, 2013, 100(3):718-724.
14.	Scott RT, Ferry K, Su J, et al. Comprehensive chromosome screening is highly predictive of the reproductive potential of human embryos:a prospective, blinded, nonelection study. Fertil Steril, 2012, 97(4):870-875.
15.	Munne S, Cohen J. Chromosome abnormalities in human embryos. Hum Reprod Update, 1998, 4(6):842-855.
16.	Alikani M, Cohen J, Tomkin G, et al. Human embryo fragmentation in vitro and its implications for pregnancy and implantation. Fertil Steril, 1999, 71(5):836-842.
17.	Forman EJ, Tao X, Ferry KM, et al. Single embryo transfer with comprehensive chromosome screening results in improved ongoing pregnancy rates and decreased miscarriage rates. Hum Reprod, 2012, 27(4):1217-1222.
18.	Yang Z, Liu J, Collins GS, et al. Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients:results from a randomized pilot study. Mol Cytogenet, 2012, 5:24.
19.	Murray S, Shetty A, Rattray A, et al. A randomized comparison of alternative methods of information provision on the acceptability of elective single embryo transfer. Hum Reprod, 2004, 19(4):911-916.
20.	袁金秋, 刘雅莉, 杨克虎.系统评价再评价纳入研究的质量评价方法调查.中国循证医学杂志, 2012, 12(2):238-242.

1. Ryan GL, Sparks AE, Sipe CS, et al. A mandatory single blastocyst transfer policy with educational campaign in a United States IVF program reduces multiple gestation rates without sacrificing pregnancy rates. Fertil Steril, 2007, 88(2):354-360.
2. Nakagawa K, Nishi Y, Sugiyama R, et al. Elective single cleavagestage embryo transfer need not result in lower pregnancy rates compared to double cleavage-stage embryo transfer. J Obstet Gynaecol Res, 2010, 36(4):777-782.
3. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. Available at:www.cochrane-handbook.org/. Accessed March 10, 2009.
4. Juni P, Altman DG, Egger M. Assessing the quality of controlled clinical trials. BMJ, 2001, 323(7303):42-46.
5. Vergouw CG, Kieslinger DC, Kostelijk EH, et al. Day 3 embryo selection by metabolomic profiling of culture medium with nearinfrared spectroscopy as an adjunct to morphology:a randomized controlled trial. Hum Reprod, 2012, 27(8):2304-2311.
6. Hardarson T, Ahlstrom A, Rogberg L, et al. Non-invasive metabolomic profiling of Day 2 and 5 embryo culture medium:a prospective randomized trial. Hum Reprod, 2012, 27(1):89-96.
7. Forman EJ, Hong KH, Ferry KM, et al. In vitro fertilization with single euploid blastocyst transfer:a randomized controlled trial. Fertil Steril, 2013, 100(1):100-107.
8. Scott RT, Upham KM, Forman EJ, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates:a randomized controlled trial. Fertil Steril, 2013, 100(3):697-703.
9. Lukassen HG, Braat DD, Wetzels AM, et al. Two cycles with single embryo transfer versus one cycle with double embryo transfer:a randomized controlled trial. Hum Reprod, 2005, 20(3):702-708.
10. Paternot G, Wetzels AM, Thonon F, et al. Intra-and interobserver analysis in the morphological assessment of early stage embryos during an IVF procedure:a multicentre study. Reprod Biol Endocrinol, 2011, 9:127.
11. Vergouw CG, Botros LL, Roos P, et al. Metabolomic profiling by near-infrared spectroscopy as a tool to assess embryo viability:a novel, non-invasive method for embryo selection. Hum Reprod, 2008, 23(7):1499-1504.
12. Seli E, Botros L, Sakkas D, et al. Noninvasive metabolomic profiling of embryo culture media using proton nuclear magnetic resonance correlates with reproductive potential of embryos in women undergoing in vitro fertilization. Fertil Steril, 2008, 90(6):2183-2189.
13. Forman EJ, Upham KM, Cheng M, et al. Comprehensive chromosome screening alters traditional morphology-based embryo selection:a prospective study of 100 consecutive cycles of planned fresh euploid blastocyst transfer. Fertil Steril, 2013, 100(3):718-724.
14. Scott RT, Ferry K, Su J, et al. Comprehensive chromosome screening is highly predictive of the reproductive potential of human embryos:a prospective, blinded, nonelection study. Fertil Steril, 2012, 97(4):870-875.
15. Munne S, Cohen J. Chromosome abnormalities in human embryos. Hum Reprod Update, 1998, 4(6):842-855.
16. Alikani M, Cohen J, Tomkin G, et al. Human embryo fragmentation in vitro and its implications for pregnancy and implantation. Fertil Steril, 1999, 71(5):836-842.
17. Forman EJ, Tao X, Ferry KM, et al. Single embryo transfer with comprehensive chromosome screening results in improved ongoing pregnancy rates and decreased miscarriage rates. Hum Reprod, 2012, 27(4):1217-1222.
18. Yang Z, Liu J, Collins GS, et al. Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients:results from a randomized pilot study. Mol Cytogenet, 2012, 5:24.
19. Murray S, Shetty A, Rattray A, et al. A randomized comparison of alternative methods of information provision on the acceptability of elective single embryo transfer. Hum Reprod, 2004, 19(4):911-916.
20. 袁金秋, 刘雅莉, 杨克虎.系统评价再评价纳入研究的质量评价方法调查.中国循证医学杂志, 2012, 12(2):238-242.

Chinese Journal of Evidence-Based Medicine

Effectiveness of Different Embryo Screening Methods before Transplantation: A Systematic Review

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