Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis

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 sho...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Andrea Busnelli, Edgardo Somigliana, Federico Cirillo, Annamaria Baggiani, Paolo Emanuele Levi-Setti
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b159be05926d40b68ab2976175e85bfa
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b159be05926d40b68ab2976175e85bfa
record_format	dspace
spelling	oai:doaj.org-article:b159be05926d40b68ab2976175e85bfa2021-12-02T10:49:16ZEfficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis10.1038/s41598-021-81439-62045-2322https://doaj.org/article/b159be05926d40b68ab2976175e85bfa2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81439-6https://doaj.org/toc/2045-2322Abstract 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.Andrea BusnelliEdgardo SomiglianaFederico CirilloAnnamaria BaggianiPaolo Emanuele Levi-SettiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-31 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Andrea Busnelli Edgardo Somigliana Federico Cirillo Annamaria Baggiani Paolo Emanuele Levi-Setti Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis
description	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.
format	article
author	Andrea Busnelli Edgardo Somigliana Federico Cirillo Annamaria Baggiani Paolo Emanuele Levi-Setti
author_facet	Andrea Busnelli Edgardo Somigliana Federico Cirillo Annamaria Baggiani Paolo Emanuele Levi-Setti
author_sort	Andrea Busnelli
title	Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis
title_short	Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis
title_full	Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis
title_fullStr	Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis
title_full_unstemmed	Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis
title_sort	efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b159be05926d40b68ab2976175e85bfa
work_keys_str_mv	AT andreabusnelli efficacyoftherapiesandinterventionsforrepeatedembryoimplantationfailureasystematicreviewandmetaanalysis AT edgardosomigliana efficacyoftherapiesandinterventionsforrepeatedembryoimplantationfailureasystematicreviewandmetaanalysis AT federicocirillo efficacyoftherapiesandinterventionsforrepeatedembryoimplantationfailureasystematicreviewandmetaanalysis AT annamariabaggiani efficacyoftherapiesandinterventionsforrepeatedembryoimplantationfailureasystematicreviewandmetaanalysis AT paoloemanuelelevisetti efficacyoftherapiesandinterventionsforrepeatedembryoimplantationfailureasystematicreviewandmetaanalysis
_version_	1718396611877404672

Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis

Ejemplares similares