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
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
Current version onlyStimulated 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Stimulated cycle vs programmed | OR 1.26 [0.49, 3.26] | 1 study · 100 participants | Very low Downgraded: risk of bias |
Clinical pregnancy rate Stimulated cycle vs programmed | OR 1.63 [1.12, 2.38] | 5 studies · 656 participants | Low Downgraded: risk of bias |
Miscarriage rate Stimulated cycle vs programmed | OR 0.79 [0.36, 1.71] | 3 studies · 355 participants | Very low Downgraded: risk of bias |
Multiple pregnancy rate Stimulated cycle vs programmed | no estimate extracted | NR | No studies |
Cycle cancellation rate Stimulated cycle vs programmed | no estimate extracted | NR | No studies |
Endometrial thickness (mm) Stimulated cycle vs programmed | no estimate extracted | 2 studies · 362 participants | Low Downgraded: risk of bias |
Other adverse effects Stimulated cycle vs programmed | no estimate extracted | NR | No 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Natural cycle vs programmed cycle | OR 0.97 [0.74, 1.28] | 4 studies · 1285 participants | Very low Downgraded: risk of bias |
Clinical pregnancy rate Natural cycle vs programmed cycle | OR 0.79 [0.62, 1.01] | 5 studies · 1249 participants | Very low Downgraded: risk of bias |
Miscarriage rate Natural cycle vs programmed cycle | OR 0.64 [0.25, 1.63] | 3 studies · 485 participants | Very low Downgraded: risk of bias |
Multiple pregnancy rate Natural cycle vs programmed cycle | no estimate extracted | NR | No studies |
Cycle cancellation rate Natural cycle vs programmed cycle | OR 0.6 [0.44, 0.82] | 1 study · 734 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Endometrial thickness (mm) Natural cycle vs programmed cycle | no estimate extracted | 3 studies · 485 participants | Low Downgraded: risk of bias |
Other adverse effects Natural cycle vs programmed cycle | no estimate extracted | NR | No 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Transdermal oestrogens vs oral oestrogens | no estimate extracted | NR | No studies |
Clinical pregnancy rate Transdermal oestrogens vs oral oestrogens | OR 0.86 [0.59, 1.25] | 3 studies · 504 participants | Low Downgraded: risk of bias |
Miscarriage rate Transdermal oestrogens vs oral oestrogens | OR 0.55 [0.27, 1.09] | 2 studies · 414 participants | Low Downgraded: risk of bias |
Multiple pregnancy rate Transdermal oestrogens vs oral oestrogens | no estimate extracted | NR | No studies |
Cycle cancellation rate Transdermal oestrogens vs oral oestrogens | no estimate extracted | NR | No studies |
Endometrial thickness (mm) Transdermal oestrogens vs oral oestrogens | no estimate extracted | NR | No studies |
Other adverse effects Transdermal oestrogens vs oral oestrogens | no estimate extracted | NR | No 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Starting administration of the progestogen earlier vs starting administration of the progestogen later | no estimate extracted | NR | No 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 participants | Moderate 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 participants | Very low Downgraded: risk of bias |
Multiple pregnancy rate Starting administration of the progestogen earlier vs starting administration of the progestogen later | no estimate extracted | 1 study · 282 participants | Very 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 participants | Moderate Downgraded: risk of bias |
Endometrial thickness Starting administration of the progestogen earlier vs starting administration of the progestogen later | no estimate extracted | NR | No studies |
Other adverse effects Starting administration of the progestogen earlier vs starting administration of the progestogen later | no estimate extracted | NR | No 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate GnRH agonists vs control | OR 2.62 [1.19, 5.78] | 1 study · 234 participants | Low Downgraded: risk of bias |
Clinical pregnancy rate GnRH agonists vs control | OR 1.08 [0.82, 1.43] | 8 studies · 1289 participants | Low Downgraded: risk of bias, imprecision |
Miscarriage rate GnRH agonists vs control | OR 0.85 [0.36, 2] | 4 studies · 828 participants | Low Downgraded: risk of bias, imprecision |
Multiple pregnancy rate GnRH agonists vs control | no estimate extracted | NR | No studies |
Cycle cancellation cycles GnRH agonists vs control | OR 0.49 [0.21, 1.17] | 2 studies · 530 participants | Low Downgraded: risk of bias, imprecision |
Endometrial thickness (mm) GnRH agonists vs control | no estimate extracted | 4 studies · 697 participants | Low Downgraded: risk of bias, imprecision |
Other adverse effects GnRH agonists vs control | no estimate extracted | NR | No 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Among different GnRH agonists vs placebo | no estimate extracted | NR | No studies |
Clinical pregnancy rate Among different GnRH agonists vs placebo | OR 1.93 [0.62, 5.98] | 1 study · 50 participants | Very low Downgraded: risk of bias |
Miscarriage rate Among different GnRH agonists vs placebo | OR 1.33 [0.36, 4.87] | 1 study · 68 participants | Very low Downgraded: risk of bias |
Multiple pregnancy rate Among different GnRH agonists vs placebo | no estimate extracted | NR | No studies |
Cycle cancellation rate Among different GnRH agonists vs placebo | no estimate extracted | NR | No studies |
Endometrial thickness (mm) Among different GnRH agonists vs placebo | no estimate extracted | NR | No studies |
Other adverse effects Among different GnRH agonists vs placebo | no estimate extracted | NR | No 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate GnRH agonists vs GnRH antagonists | no estimate extracted | NR | No studies |
Clinical pregnancy rate GnRH agonists vs GnRH antagonists | OR 0.62 [0.42, 0.9] | 1 study · 473 participants | Moderate Downgraded: risk of bias |
Miscarriage rate GnRH agonists vs GnRH antagonists | OR 0.75 [0.38, 1.49] | 1 study · 473 participants | Low Downgraded: risk of bias |
Multiple pregnancy rate GnRH agonists vs GnRH antagonists | OR 0.69 [0.45, 1.07] | 1 study · 473 participants | Low Downgraded: risk of bias |
Cycle cancellation rate GnRH agonists vs GnRH antagonists | no estimate extracted | NR | No studies |
Endometrial thickness (mm) GnRH agonists vs GnRH antagonists | no estimate extracted | NR | No studies |
Other adverse effects GnRH agonists vs GnRH antagonists | no estimate extracted | NR | No 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Aspirin vs control | OR 6 [1.48, 24.3] | 1 study · 60 participants | Very low Downgraded: risk of bias |
Clinical pregnancy rate Aspirin vs control | OR 3.33 [1, 11.14] | 1 study · 60 participants | Very low Downgraded: risk of bias |
Miscarriage rate Aspirin vs control | no estimate extracted | NR | No studies |
Multiple pregnancy rate Aspirin vs control | no estimate extracted | NR | No studies |
Cycle cancellation rate Aspirin vs control | no estimate extracted | NR | No studies |
Endometrial thickness (mm) Aspirin vs control | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias |
Other adverse effects Aspirin vs control | no estimate extracted | NR | No 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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Live birth rate Steroids vs control | OR 0.66 [0.14, 3.11] | 1 study · 99 participants | Very low Downgraded: risk of bias |
Clinical pregnancy rate Steroids vs control | OR 0.9 [0.4, 2.03] | 2 studies · 160 participants | Very low Downgraded: risk of bias |
Miscarriage rate Steroids vs control | OR 1.49 [0.32, 7.03] | 2 studies · 160 participants | Very low Downgraded: risk of bias |
Multiple pregnancy rate Steroids vs control | no estimate extracted | NR | No studies |
Cycle cancellation rate Steroids vs control | no estimate extracted | NR | No studies |
Endometrial thickness (mm) Steroids vs control | no estimate extracted | NR | No studies |
Other adverse effects Steroids vs control | no estimate extracted | NR | No studies |
Starting progesterone either on the oocyte pick‐up day or the day after compared to the day before
Population: oocyte recipients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical Pregnancy Rate ( Starting progesterone either on the oocyte pick‐up day or the day after vs the day before | OR 1.4 [1.05, 1.87] | 1 study · 282 participants | Moderate |
Cancellation rate ( Starting progesterone either on the oocyte pick‐up day or the day after vs the day before | OR 0.31 [0.12, 0.76] | 1 study · 282 participants | Moderate |
Intramuscular progesterone versus vaginal progesterone for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
Population: patients with women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical Pregnancy Rate Intramuscular progesterone vs vaginal progesterone | OR 1.44 [0.98, 2.1] | 4 studies · 655 participants | Moderate Downgraded: imprecision |