<strong>Study Question:</strong> The question: is there any difference in pregnancy rate between embryo transfer day 5 and day 6 in IVF? What Is Known Already? Blastocyst transfer is increasingly popular i...<strong>Study Question:</strong> The question: is there any difference in pregnancy rate between embryo transfer day 5 and day 6 in IVF? What Is Known Already? Blastocyst transfer is increasingly popular in assisted reproductive technology (ART) centers today. Very few articles concentrate on comparing Day 5 and Day 6 embryo transfer with conflict results. <strong>Objective, Study Design:</strong> Systematic review and meta-analysis of published controlled studies. Searches conducted from 2001-2020 on PubMed. Medline, EMBASE, and ISI Web of Science Electronic database is used to collect data, using the following search terms: blastocyst, Day 5, Day 6, embryo transfer (E.T.) and pregnancy rate. <strong>Materials, Setting, Methods:</strong> A total of 6 full-text articles preselected from 211 references, based on title and abstract. Two independent reviewers performed data selection and extraction according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). This systematic review was conducted according to (PICO) standard. Random-effect meta-analysis performed on all data (overall analysis). <strong>Results and the Role of Chance:</strong> Data from 6 relevant articles were extracted and integrated into the meta-analysis that reported clinical pregnancy rate (CPR) as an outcome in 5640 cycles, 2274 cycle had embryo transfer at day 6 and the control was 3366 cycle had embryo transfer day 5 showed a significantly higher clinical pregnancy rate following Day 5 embryo transfer compared with Day 6 embryo transfer with odd ratio and 95% confidence limit 0.73 (0.66 - 0.82)<em> p</em> value < 0.000. Sensitivity analysis led to similar results and conclusions.<strong> Limitations, Reasons for Caution: </strong>The validity of meta-analysis results depends mainly on the quality and the number of published studies available. Indeed, this meta-analysis included no randomized controlled trial (RCT). <strong>Wider Implications of the Findings: </strong>In regards to the results of this original meta-analysis, ART practitioners should preferably transfer D5 rather than D6 blastocysts. Further RCTs are needed to address the question of whether D6 embryos should be transported.展开更多
Background: Induction of labor is the stimulation of the uterus to initiate the labor process whether by administering oxytocin, prostaglandin or reputing the membrane [1]. It was realized that the number of induction...Background: Induction of labor is the stimulation of the uterus to initiate the labor process whether by administering oxytocin, prostaglandin or reputing the membrane [1]. It was realized that the number of induction of labor patients was thought to be increasing in comparison with the spontaneous labor patients. Therefore, the complications of induced labor were higher. A detailed analysis was needed to confirm that. Objective: The aim of the study is to analyze the outcomes between spontaneous versus induced labor. Materials and Methods: A retrospective analysis was conducted at our tertiary care university hospital, in the period from December 2015 to December 2016 when 311 women were divided into two groups: group 1, women who had spontaneous labor (n = 106) compared with group 2, women who were labor induced (n = 205). Complications of pregnancy, delivery type, tear, episiotomy, blood transfusion and instruments used were analyzed retrospectively. Results: The mean ± SD of baseline characteristics, like age, height, weight, BMI and hemoglobin level for all study samples was 28.59 ± 5.95 years, 1.58 ± 0.06 m, 71.77 ± 13.42 kg, 28.59 ± 5.89 kg/m2 and 11.08 ± 1.45 g/dl respectively. A statistically significant difference was noticed in the duration of labor between spontaneous and induced labor (95% CI: 9.194 - 152.130;p-value 0.004 and OR: 0.239). There was no significant difference in complications, delivery type (Spontaneous Vaginal Delivery (SVD) or other), blood transfusion, and instrument used between women who had spontaneous labor versus induced labor. However, significant differences in tear (95% CI: 4.354 - 0.996;p-value 0.035) and episiotomy (95% CI: 0.928 - 0.224;p-value 0.028) were found between the two groups. In conclusion, the induced labor was found to be associated with high incidence of duration of labor, tear and episiotomy. Patients should always be counseled when there it is an option between the two delivery types.展开更多
文摘<strong>Study Question:</strong> The question: is there any difference in pregnancy rate between embryo transfer day 5 and day 6 in IVF? What Is Known Already? Blastocyst transfer is increasingly popular in assisted reproductive technology (ART) centers today. Very few articles concentrate on comparing Day 5 and Day 6 embryo transfer with conflict results. <strong>Objective, Study Design:</strong> Systematic review and meta-analysis of published controlled studies. Searches conducted from 2001-2020 on PubMed. Medline, EMBASE, and ISI Web of Science Electronic database is used to collect data, using the following search terms: blastocyst, Day 5, Day 6, embryo transfer (E.T.) and pregnancy rate. <strong>Materials, Setting, Methods:</strong> A total of 6 full-text articles preselected from 211 references, based on title and abstract. Two independent reviewers performed data selection and extraction according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). This systematic review was conducted according to (PICO) standard. Random-effect meta-analysis performed on all data (overall analysis). <strong>Results and the Role of Chance:</strong> Data from 6 relevant articles were extracted and integrated into the meta-analysis that reported clinical pregnancy rate (CPR) as an outcome in 5640 cycles, 2274 cycle had embryo transfer at day 6 and the control was 3366 cycle had embryo transfer day 5 showed a significantly higher clinical pregnancy rate following Day 5 embryo transfer compared with Day 6 embryo transfer with odd ratio and 95% confidence limit 0.73 (0.66 - 0.82)<em> p</em> value < 0.000. Sensitivity analysis led to similar results and conclusions.<strong> Limitations, Reasons for Caution: </strong>The validity of meta-analysis results depends mainly on the quality and the number of published studies available. Indeed, this meta-analysis included no randomized controlled trial (RCT). <strong>Wider Implications of the Findings: </strong>In regards to the results of this original meta-analysis, ART practitioners should preferably transfer D5 rather than D6 blastocysts. Further RCTs are needed to address the question of whether D6 embryos should be transported.
文摘Background: Induction of labor is the stimulation of the uterus to initiate the labor process whether by administering oxytocin, prostaglandin or reputing the membrane [1]. It was realized that the number of induction of labor patients was thought to be increasing in comparison with the spontaneous labor patients. Therefore, the complications of induced labor were higher. A detailed analysis was needed to confirm that. Objective: The aim of the study is to analyze the outcomes between spontaneous versus induced labor. Materials and Methods: A retrospective analysis was conducted at our tertiary care university hospital, in the period from December 2015 to December 2016 when 311 women were divided into two groups: group 1, women who had spontaneous labor (n = 106) compared with group 2, women who were labor induced (n = 205). Complications of pregnancy, delivery type, tear, episiotomy, blood transfusion and instruments used were analyzed retrospectively. Results: The mean ± SD of baseline characteristics, like age, height, weight, BMI and hemoglobin level for all study samples was 28.59 ± 5.95 years, 1.58 ± 0.06 m, 71.77 ± 13.42 kg, 28.59 ± 5.89 kg/m2 and 11.08 ± 1.45 g/dl respectively. A statistically significant difference was noticed in the duration of labor between spontaneous and induced labor (95% CI: 9.194 - 152.130;p-value 0.004 and OR: 0.239). There was no significant difference in complications, delivery type (Spontaneous Vaginal Delivery (SVD) or other), blood transfusion, and instrument used between women who had spontaneous labor versus induced labor. However, significant differences in tear (95% CI: 4.354 - 0.996;p-value 0.035) and episiotomy (95% CI: 0.928 - 0.224;p-value 0.028) were found between the two groups. In conclusion, the induced labor was found to be associated with high incidence of duration of labor, tear and episiotomy. Patients should always be counseled when there it is an option between the two delivery types.
