Propensity score-matched study and meta-analysis of cumulative outcomes of day 2/3 versus day 5/6 embryo transfers

Abstract

The superiority of the cumulative outcomes of day 5/6 embryo transfer to those of day 2/3 embryo transfer in infertile couples has been debated. This retrospective study included data collected from 1051 patients from July 2011 to June 2014. Multiple maternal baseline covariates were subjected to propensity score matching analysis, and each day 5/6 group woman was matched to one day 2/3 group woman. A systematic meta-analysis was conducted to validate the results. After matching was completed, 217 patients on the day 2/3 group were matched with those on the day 5/6 group, and no significant differences in the baseline characteristics were observed between the two groups. The cumulative pregnancy rate (57.14% vs. 53.46%, OR 1.16, 95% CI 0.79–1.70) and cumulative live birth rate (53.00% vs. 49.77%, OR 1.14, 95% CI 0.78–1.66) of day 5/6 embryo transfers were higher than those of day 2/3 embryo transfers, but this difference was not significant. The mean cycles per live birth and mean days per live birth in the day 5/6 group were significantly lower than those in the day 2/3 group. This study demonstrated that day 5/6 embryo transfer is a more cost-effective and time-efficient policy than day 2/3 embryo transfer to produce a live baby.

Keywords

blastocyst / embryo transfer / cumulative pregnancy rate / cumulative live birth rate / IVF

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Acknowledgements

This work was supported by the Ministry of Health Public Foundation of China (No.201402004), National Basic Research Program of China (973 Program, No. 2007CB948104), Huazhong University of Science and Technology Independent Innovation Research Fund (No. 2013ZHYX010), Specialized Research Fund for the Commission of Hubei Province (No. JS-2011002), and National Natural Science Foundation of China (No. 81601348).

Compliance with ethics guidelines

Ye Yin, Ge Chen, Kezhen Li, Qiuyue Liao, Sijia Zhang, Nieying Ma, Jing Chen, Yan Zhang, and Jihui Ai declare no conflict of interest with regard to this work. All included procedures were conducted in accordance with the ethical standards of the Responsible Committee on Human Experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients upon enrollment to the study.

Electronic Supplementary Material

Supplementary material is available in the online version of this article at http://dx.doi.org/10.1007/s11684-017-0535-6 and is accessible to authorized users.

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