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Research Article Open Access

Assessing the Effectiveness of Sequential Embryo Transfer in the RIF Patients


Purpose: This meta-analysis aims to evaluate the effectiveness of sequential embryo transfer (cleavage embryo transfer followed by blastocyst embryo transfer in the same cycle) in patients with repeated implant failure.

Methods: The search was performed in the English databases. The time range was from library building to August 20, 2023. Ultimately, the primary outcome measures were implantation rate and clinical pregnancy rate. The secondary indicators were miscarriage rate, multiple pregnancy rate, chemical pregnancy rate and ongoing pregnancy rate. The screening of articles was performed with Endnote, and data were analyzed with Review Manager 5.4.

Results: Our results showed that compared with control group, sequential embryo transfer was associated with higher implantation rate (RR=1.66, 95% CI: 1.34-2.05, P<0.00001, I2=0.0%) and clinical pregnancy rate (RR=1.58, 95% CI: 1.31- 1.91, P<0.00001, I2=18%). Groups did not differ statistically in miscarriage rate (RR=1.16, 90% CI: 0.64-2.10, P=0.62. The sequential group also did not show higher multiple pregnancy rate (RR=1.17, 90% CI: 0.80-1.72, P=0.42. Only two articles counted the chemical pregnancy rate and ongoing pregnancy rate, in which no differences were found (RR=1.17, 90% CI: 0.91-1.49, P=0.22; RR=0.79, 90% CI: 0.50-1.24, P=0.30). Only one article counted the live birth rate, thus preventing the meta-analysis and not yielding the live birth rate results for the sequential embryo transfer group.

Conclusion: Sequential embryo transfer contributes to higher implantation rate and clinical pregnancy rate in RIF patients, which is instructive for future clinical work.

Xingnan Liu*, Na Zhang*

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