Efficacy of therapies and interventions for repeated embryo implantation failure : a systematic review and meta-analysis
Articolo
Data di Pubblicazione:
2021
Citazione:
Efficacy of therapies and interventions for repeated embryo implantation failure : a systematic review and meta-analysis / A. Busnelli, E. Somigliana, F. Cirillo, A. Baggiani, P.E. Levi-Setti. - In: SCIENTIFIC REPORTS. - ISSN 2045-2322. - 11:1(2021 Jan 18), pp. 1747.1-1747.31. [10.1038/s41598-021-81439-6]
Abstract:
The aim of the present systematic review and meta-analysis was to assess the effect of the different therapeutic options for repeated embryo implantation failure (RIF) on a subsequent IVF cycle outcome. Twenty-two RCTs and nineteen observational studies were included. Pooling of results showed a beneficial effect of intrauterine PBMC infusion on both CPR (RR 2.18; 95% CI 1.58–3.00; p < 0.00001; OR 2.03; 95% CI 1.22–3.36; p = 0.006) and LBR (RR 2.41; 95% CI 1.40–4.16; p = 0.002; OR 3.73; 95% CI 1.13–12.29; p = 0.03), of subcutaneous G-CSF administration on CPR (RR 2.29; 95% CI 1.58–3.31; p < 0.0001) and of intrauterine PRP infusion on CPR (RR 2.45; 95% CI 1.55–3.86; p = 0.0001). Observational studies also demonstrated a positive effect of IVIG and intrauterine hCG infusion on both CPR and LBR and of atosiban on CPR. Studies investigating intrauterine G-CSF infusion, LMWH, intravenous intralipid, hysteroscopy, blastocyst-stage ET, ZIFT, PGT-A and AH failed to observe an impact on IVF outcome. The quality of the evidence that emerged from RCTs focused on intrauterine PBMC infusion and subcutaneous G-CSF administration was moderate. For all other therapies/interventions it varied from low to very low. In conclusion, intrauterine PBMC infusion and subcutaneous G-CSF administration are the most promising therapeutic options for RIF. However, further well conducted RCTs are necessary before their introduction into clinical practice.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
abortion, spontaneous; birth rate; female; fertilization in vitro; humans; pregnancy; pregnancy rate; randomized controlled trials as topic; treatment outcome; embryo implantation
Elenco autori:
A. Busnelli, E. Somigliana, F. Cirillo, A. Baggiani, P.E. Levi-Setti
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