Cochrane · systematic review · CD006359

Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Glujovsky, D, Pesce, R, Sueldo, C, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Gynaecology and Fertility2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
63
current version
GRADE rated
31
No studies
32
Included studies
NR
No studies 32 · 50.8%Ungraded 0 · 0%Very low 15 · 23.8%Low 12 · 19%Moderate 4 · 6.3%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Stimulated cycle compared to programmed for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Population: women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate
Stimulated cycle vs programmed
OR 1.26 [0.49, 3.26]1 study · 100 participantsVery low
Downgraded: risk of bias
Clinical pregnancy rate
Stimulated cycle vs programmed
OR 1.63 [1.12, 2.38]5 studies · 656 participantsLow
Downgraded: risk of bias
Miscarriage rate
Stimulated cycle vs programmed
OR 0.79 [0.36, 1.71]3 studies · 355 participantsVery low
Downgraded: risk of bias
Multiple pregnancy rate
Stimulated cycle vs programmed
no estimate extractedNRNo studies
Cycle cancellation rate
Stimulated cycle vs programmed
no estimate extractedNRNo studies
Endometrial thickness (mm)
Stimulated cycle vs programmed
no estimate extracted2 studies · 362 participantsLow
Downgraded: risk of bias
Other adverse effects
Stimulated cycle vs programmed
no estimate extractedNRNo studies

Natural cycle compared to programmed cycle for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Population: women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate
Natural cycle vs programmed cycle
OR 0.97 [0.74, 1.28]4 studies · 1285 participantsVery low
Downgraded: risk of bias
Clinical pregnancy rate
Natural cycle vs programmed cycle
OR 0.79 [0.62, 1.01]5 studies · 1249 participantsVery low
Downgraded: risk of bias
Miscarriage rate
Natural cycle vs programmed cycle
OR 0.64 [0.25, 1.63]3 studies · 485 participantsVery low
Downgraded: risk of bias
Multiple pregnancy rate
Natural cycle vs programmed cycle
no estimate extractedNRNo studies
Cycle cancellation rate
Natural cycle vs programmed cycle
OR 0.6 [0.44, 0.82]1 study · 734 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency
Endometrial thickness (mm)
Natural cycle vs programmed cycle
no estimate extracted3 studies · 485 participantsLow
Downgraded: risk of bias
Other adverse effects
Natural cycle vs programmed cycle
no estimate extractedNRNo studies

Transdermal oestrogens compared to oral oestrogens for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Population: women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate
Transdermal oestrogens vs oral oestrogens
no estimate extractedNRNo studies
Clinical pregnancy rate
Transdermal oestrogens vs oral oestrogens
OR 0.86 [0.59, 1.25]3 studies · 504 participantsLow
Downgraded: risk of bias
Miscarriage rate
Transdermal oestrogens vs oral oestrogens
OR 0.55 [0.27, 1.09]2 studies · 414 participantsLow
Downgraded: risk of bias
Multiple pregnancy rate
Transdermal oestrogens vs oral oestrogens
no estimate extractedNRNo studies
Cycle cancellation rate
Transdermal oestrogens vs oral oestrogens
no estimate extractedNRNo studies
Endometrial thickness (mm)
Transdermal oestrogens vs oral oestrogens
no estimate extractedNRNo studies
Other adverse effects
Transdermal oestrogens vs oral oestrogens
no estimate extractedNRNo studies

Starting administration of the progestogen earlier compared to starting administration of the progestogen later for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Population: women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate
Starting administration of the progestogen earlier vs starting administration of the progestogen later
no estimate extractedNRNo studies
Clinical pregnancy rate
Starting administration of the progestogen earlier vs starting administration of the progestogen later
OR 1.87 [1.13, 3.08]1 study · 282 participantsModerate
Downgraded: risk of bias
Miscarriage Rate
Starting administration of the progestogen earlier vs starting administration of the progestogen later
OR 0.45 [0.16, 1.25]1 study · 191 participantsVery low
Downgraded: risk of bias
Multiple pregnancy rate
Starting administration of the progestogen earlier vs starting administration of the progestogen later
no estimate extracted1 study · 282 participantsVery low
Downgraded: risk of bias
Cycle cancellation rate
Starting administration of the progestogen earlier vs starting administration of the progestogen later
OR 0.28 [0.11, 0.74]1 study · 282 participantsModerate
Downgraded: risk of bias
Endometrial thickness
Starting administration of the progestogen earlier vs starting administration of the progestogen later
no estimate extractedNRNo studies
Other adverse effects
Starting administration of the progestogen earlier vs starting administration of the progestogen later
no estimate extractedNRNo studies

GnRH agonists compared to control for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Population: women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate
GnRH agonists vs control
OR 2.62 [1.19, 5.78]1 study · 234 participantsLow
Downgraded: risk of bias
Clinical pregnancy rate
GnRH agonists vs control
OR 1.08 [0.82, 1.43]8 studies · 1289 participantsLow
Downgraded: risk of bias, imprecision
Miscarriage rate
GnRH agonists vs control
OR 0.85 [0.36, 2]4 studies · 828 participantsLow
Downgraded: risk of bias, imprecision
Multiple pregnancy rate
GnRH agonists vs control
no estimate extractedNRNo studies
Cycle cancellation cycles
GnRH agonists vs control
OR 0.49 [0.21, 1.17]2 studies · 530 participantsLow
Downgraded: risk of bias, imprecision
Endometrial thickness (mm)
GnRH agonists vs control
no estimate extracted4 studies · 697 participantsLow
Downgraded: risk of bias, imprecision
Other adverse effects
GnRH agonists vs control
no estimate extractedNRNo studies

Among different GnRH agonists compared to placebo for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Population: women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate
Among different GnRH agonists vs placebo
no estimate extractedNRNo studies
Clinical pregnancy rate
Among different GnRH agonists vs placebo
OR 1.93 [0.62, 5.98]1 study · 50 participantsVery low
Downgraded: risk of bias
Miscarriage rate
Among different GnRH agonists vs placebo
OR 1.33 [0.36, 4.87]1 study · 68 participantsVery low
Downgraded: risk of bias
Multiple pregnancy rate
Among different GnRH agonists vs placebo
no estimate extractedNRNo studies
Cycle cancellation rate
Among different GnRH agonists vs placebo
no estimate extractedNRNo studies
Endometrial thickness (mm)
Among different GnRH agonists vs placebo
no estimate extractedNRNo studies
Other adverse effects
Among different GnRH agonists vs placebo
no estimate extractedNRNo studies

GnRH agonists compared to GnRH antagonists for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Population: women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate
GnRH agonists vs GnRH antagonists
no estimate extractedNRNo studies
Clinical pregnancy rate
GnRH agonists vs GnRH antagonists
OR 0.62 [0.42, 0.9]1 study · 473 participantsModerate
Downgraded: risk of bias
Miscarriage rate
GnRH agonists vs GnRH antagonists
OR 0.75 [0.38, 1.49]1 study · 473 participantsLow
Downgraded: risk of bias
Multiple pregnancy rate
GnRH agonists vs GnRH antagonists
OR 0.69 [0.45, 1.07]1 study · 473 participantsLow
Downgraded: risk of bias
Cycle cancellation rate
GnRH agonists vs GnRH antagonists
no estimate extractedNRNo studies
Endometrial thickness (mm)
GnRH agonists vs GnRH antagonists
no estimate extractedNRNo studies
Other adverse effects
GnRH agonists vs GnRH antagonists
no estimate extractedNRNo studies

Aspirin compared to control for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Population: women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate
Aspirin vs control
OR 6 [1.48, 24.3]1 study · 60 participantsVery low
Downgraded: risk of bias
Clinical pregnancy rate
Aspirin vs control
OR 3.33 [1, 11.14]1 study · 60 participantsVery low
Downgraded: risk of bias
Miscarriage rate
Aspirin vs control
no estimate extractedNRNo studies
Multiple pregnancy rate
Aspirin vs control
no estimate extractedNRNo studies
Cycle cancellation rate
Aspirin vs control
no estimate extractedNRNo studies
Endometrial thickness (mm)
Aspirin vs control
no estimate extracted1 study · 60 participantsVery low
Downgraded: risk of bias
Other adverse effects
Aspirin vs control
no estimate extractedNRNo studies

Steroids compared to control for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes

Population: women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
7 questions
OutcomeEffectEvidenceStatus / GRADE
Live birth rate
Steroids vs control
OR 0.66 [0.14, 3.11]1 study · 99 participantsVery low
Downgraded: risk of bias
Clinical pregnancy rate
Steroids vs control
OR 0.9 [0.4, 2.03]2 studies · 160 participantsVery low
Downgraded: risk of bias
Miscarriage rate
Steroids vs control
OR 1.49 [0.32, 7.03]2 studies · 160 participantsVery low
Downgraded: risk of bias
Multiple pregnancy rate
Steroids vs control
no estimate extractedNRNo studies
Cycle cancellation rate
Steroids vs control
no estimate extractedNRNo studies
Endometrial thickness (mm)
Steroids vs control
no estimate extractedNRNo studies
Other adverse effects
Steroids vs control
no estimate extractedNRNo studies