Colours in the cells indicate the confidence in the evidence: grey, low pink, very low. The evidence is graded using CINeMA system approach for network meta-analysis.
Cells in bold print indicate significant results. In the left lower half, values greater than 1 favour the column-defining treatment and in the upper right half, those values greater than 1 favour the row-defining treatment. Effect sizes represent summary odds ratios and 95% confidence intervals. Comparisons between treatments should be read from left to right and the estimate is in the cell in common between the column-defining treatment and the row-defining treatment. Results of the network meta-analysis are presented in the left lower half and results from pairwise meta-analysis in the upper right half, if available. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. Natural cycle treatment has a higher chance of live birth and lower risks of PIH, PPH and VPTB than AC for endometrial preparation in women receiving FET cycles.Įndometrial preparation Frozen–thawed embryo transfer Maternal and perinatal outcomes Meta-analysis Pregnancy rate. Women who achieved pregnancy after AC were at an increased risk of pregnancy-induced hypertension (OR 1.82, 1.37 to 2.38), postpartum haemorrhage (OR 2.08, 1.61 to 2.78) and very preterm birth (OR 2.08, 1.45 to 2.94) compared with those after tNC. In pairwise meta-analyses of observational studies, AC was associated with significant lower live birth rates compared with tNC (OR 0.81, 0.70 to 0.93) and mNC (OR 0.85, 0.77 to 0.93). In a network meta-analysis, AC ranked last in effectiveness, with lower live birth rates when compared with other endometrial preparation protocols. Twenty-six RCTs and 113 cohort studies were included in the meta-analyses. Primary outcome was live birth presented as odds ratio (OR) with 95% confidence intervals (CIs). Meta-analyses were performed within random effects models. Randomised controlled trials (RCTs) or observational studies comparing 7 treatment options (natural cycle with or without human chorionic gonadotrophin trigger (mNC or tNC), artificial cycle with or without gonadotropin-releasing hormone agonist suppression (AC+GnRH or AC), aromatase inhibitor, clomiphene citrate, gonadotropin or follicle stimulating hormone) in FET cycles were included. Systematic review with meta-analysis was performed by electronic searching of MEDLINE, the Cochrane Library, Embase, and Google Scholar up to Dec 26, 2020. To compare the effects of different endometrial preparation protocols for frozen-thawed embryo transfer (FET) cycles and present treatment hierarchy.
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