The Effect of Post warming Culture Period Between Thawing and Transfer of Cryopreserved Embryos on Reproductive Outcomes After In Vitro Fertilization (IVF): A Systematic Review and Meta-analysis

Sordia-Hernandez, Luis H; Martinez, Felipe A; Orozco, Eduardo; Flores-Rodriguez, Andrea; Leyva-Camacho, Paloma C; Alvarez-Villalobos, Neri; Zuñiga-Hernandez, Jorge

doi:10.18502/jri.v22i2.5792

The Effect of Post warming Culture Period Between Thawing and Transfer of Cryopreserved Embryos on Reproductive Outcomes After In Vitro Fertilization (IVF): A Systematic Review and Meta-analysis

Authors

Luis H Sordia-Hernandez ¹

Felipe A Martinez ¹

Eduardo Orozco ¹

Andrea Flores-Rodriguez ²

Paloma C Leyva-Camacho ²

Neri Alvarez-Villalobos ²

Jorge Zuñiga-Hernandez ²

¹ Department of Gynecology and Obstetrics, University Hospital “Dr. Jose Eleuterio González” Universidad Autónoma de Nuevo León, Monterrey, Mexico

² Plataforma INVEST Medicina UANL–KER Unit Mayo Clinic (KER Unit México), Universidad Autonoma de Nuevo Leon, Monterrey, Mexico

10.18502/jri.v22i2.5792

Abstract

Background: The purpose of this study was to evaluate the effect of post warming culture period between thawing and transfer of cryopreserved embryos on reproduc-tive outcomes after in vitro fertilization (IVF). Methods: An extensive literature search was performed using PubMed, EmBase, and the Cochrane library from January 2000 to August 2019. A systematic review and meta–analysis of clinical trials was performed in this manuscript. The trials represented patients with embryo transfers of at least one previously cryopreserved good quality embryo. Main outcome measures of the study included clinical preg-nancy rate, live birth rate, miscarriage rate, and ectopic pregnancy rate. Results: A total of 5338 trial/abstracts were identified through a literature search. Totally, five studies were included in the systematic review, and three in the final meta–analysis. The studies included 1717 embryo transfers, 605 after short culture, and 1112 after long culture. The clinical pregnancy rate (CPR) was the most con-sistent outcome reported. The CPR was slightly better after short time culture with a RR of 1.09 (0.95–1.26, 95%CI) but this difference was not statistically significant. The great heterogenicity in the results reported in the included studies made it impossible to compare all planned outcomes. Conclusion: There are no differences in reproductive outcomes if cryopreserved embryos are transferred after overnight culture or after two hours of culture follow-ing thawing. Due to small number and the poor quality of trials reported on this topic, the results of this review should be treated with caution.

Keywords

Cryopreservation

Embryo transfer

In vitro fertilization

Intracytoplasmic Sperm Injection

Rienzi L, Gracia C, Maggiulli R, LaBarbera AR, Kaser DJ, Ubaldi FM, et al. Oocyte. embryo and blastocyst cryopreservation in ART: systematic review an meta analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum Reprod Update. 2017;23(2):139-55.

Shi Q, Xie Y, Wang Y, Li S. Vitrification versus slow freezing for human ovarian tissue cryopreservation: a systematic review and meta-anlaysis. Sci Rep. 2017;7(1):8538.

Rato ML, Gouveia-Oliveira A, Plancha CE. Influence of post-thaw culture on the developmental potential of human frozen embryos. J Assist Reprod Genet. 2012;29(8):789-95.

Hartshorne GM, Elder K, Crow J, Dyson H, Edwards RG. The influence of in-vitro development upon post-thaw survival and implantation of cryopreserved human blastocysts. Hum Reprod. 1991;6(1):136-41.

Fang C, Yue CM, Huang R, Wei LN, Jia L. Pregnancy outcomes of blas-tocysts cultured overnight after thawing. Arch Gynecol Obstet. 2016;293(6):1347-56.

Wang H, Ou Z, Chen Z, Yang L, Sun L. Influence of different post-thaw culture time on the clinical outcomes of different quality embryos. Adv Clin Exp Med. 2019;28(4):523-7.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PloS Med. 2009;6(7):e1000097.

Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions. 2nd ed. Chichester (UK): John Wiley & Sons; 2019. 27 p.

Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924-6.

Herbemont C, Chekroune S, Bonan S, Cedrin-Durnerin I, Vivot A, Sonigo C, et al. Impact of post-warming culture duration on clinical outcomes of vitrified good-quality blastocyst transfers: a prospective randomized study. Fertil Steril. 2018;110(7):1290-7.

Agha-Rahimi A, Omidi M, Akyash F, Faramarzi A, Farshchi FA. Does overnight culture of cleaved embryos improve pregnancy rate in vitrified-warmed embryo transfer programme? Malays J Med Sci. 2019;26(2):52-8.

Jin R, Tong X, Wu L, Luan H, Zhou G, Johansson L, et al. Extended culture of vitrified–warmed embryos in day-3 embryo transfer cycles: a randomized controlled pilot study. Reprod Biomed Online. 2013;26(4):384-92.

Joshi BV, Manish R, Banker MR, Patel PM, Preeti B, Shah PB. Transfer of human frozen-thawed embryos with further cleavage during culture increases pregnancy rates. J Hum Reprod Sci. 2010;3(2):76-9.

Griesinger G. Beware of the ‘implantation rate’! Why the outcome parameter ‘implantation rate’ should be abandoned from infertility research. Hum Reprod. 2016;31(2):249-51.

Munne S, Alikani M, Tomkin G, Grifo J, Cohen J. Embryo morphology, developmental rates, and maternal age are correlated with chromo-some abnormalities. Fertil Steril. 1995;64(2):382-91.

Tang R, Catt J, Howlett D. Towards defining parameters for a successful single embryo transfer in frozen cycles. Hum Reprod. 2006;21(5):1179-83.