Assisted reproductive technology: an overview of Cochrane Reviews
- PMID: 30117155
- PMCID: PMC6953328
- DOI: 10.1002/14651858.CD010537.pub5
Assisted reproductive technology: an overview of Cochrane Reviews
Abstract
Background: As many as one in six couples will encounter problems with fertility, defined as failure to achieve a clinical pregnancy after regular intercourse for 12 months. Increasingly, couples are turning to assisted reproductive technology (ART) for help with conceiving and ultimately giving birth to a healthy live baby of their own. Fertility treatments are complex, and each ART cycle consists of several steps. If one of these steps is incorrectly applied, the stakes are high as conception may not occur. With this in mind, it is important that each step of the ART cycle is supported by good evidence from well-designed studies.
Objectives: To summarise the evidence from Cochrane systematic reviews on procedures and treatment options available to couples with subfertility undergoing assisted reproductive technology (ART) procedures.
Methods: Published Cochrane systematic reviews of couples undergoing ART procedures (in vitro fertilisation or intracytoplasmic sperm injection) were eligible for inclusion in the overview. We also identified Cochrane reviews in preparation, for future inclusion.The primary outcome of the overview was live birth or the composite outcome live birth or ongoing pregnancy, as reported by the included reviews. Our secondary outcomes were clinical pregnancy, multiple pregnancy, miscarriage, and ovarian hyperstimulation syndrome. We excluded studies of intrauterine insemination and ovulation induction.We undertook selection of systematic reviews, data extraction, and quality assessment in duplicate. We assessed review quality by using the AMSTAR tool. We organised reviews by their relevance to specific stages in the ART cycle. We summarised their findings in the text and reported data for each outcome in 'Additional tables'.
Main results: We included 68 systematic reviews published in the Cochrane Library up to May 2018. All were of high quality. These reviews identified 38 interventions that were effective (n = 23) or promising (n = 15), and they identified 19 interventions that were ineffective (n = 2) or possibly ineffective (n = 17). For 15 interventions, review authors were unable to draw conclusions owing to lack of evidence.We identified an additional 11 protocols and four titles for future inclusion in this overview.
Authors' conclusions: This overview provides the most up-to-date evidence on ART cycles from systematic reviews of randomised controlled trials. Fertility treatments are costly, and the stakes are high. Using the best available evidence to optimise outcomes is best practice. Evidence from this overview could be used to develop clinical practice guidelines and protocols that can be applied in daily clinical practice to improve live birth rates and reduce rates of multiple pregnancy, cycle cancellation, and ovarian hyperstimulation syndrome.
Conflict of interest statement
Professor Farquhar, and Jane Marjoribanks are authors on some of the included reviews. They have no conflicts of interest related to commercial funding.
Professor Farquhar is a director/shareholder of a fertility/gynaecology clinic and undertakes private practice within those premises.
Update of
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References
References to included reviews
Abou‐Setta 2014
Akhtar 2013
Al‐Inany 2016
Albuquerque 2013
-
- Albuquerque LET, Tso LO, Saconato H, Albuquerque MCRM, Macedo CR. Depot versus daily administration of gonadotrophin‐releasing hormone agonist protocols for pituitary down regulation in assisted reproduction cycles. Cochrane Database of Systematic Reviews 2013, Issue 1. [DOI: 10.1002/14651858.CD002808.pub3] - DOI - PMC - PubMed
Allersma 2013
Anderson 2010
Armstrong 2015
Ata 2018
-
- Ata B, Abou‐Setta AM, Seyhan A, Buckett W. Application of seminal plasma to female genital tract prior to embryo transfer in assisted reproductive technology cycles (IVF, ICSI and frozen embryo transfer). Cochrane Database of Systematic Reviews 2018, Issue 2. [DOI: 10.1002/14651858.CD011809.pub2] - DOI - PMC - PubMed
Benschop 2010
Bontekoe 2012
Bontekoe 2014
Boomsma 2012
Brown 2016
Brown 2016a
Carney 2012
Cheong 2013
Craciunas 2016
D'Angelo 2007
D'Angelo 2017
Derks 2009
Duffy 2010
Farquhar 2017
-
- Farquhar C, Rombauts L, Kremer JAM, Lethaby A, Ayeleke RO. Oral contraceptive pill, progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques. Cochrane Database of Systematic Reviews 2017, Issue 5. [DOI: 10.1002/14651858.CD006109.pub3] - DOI - PMC - PubMed
Georgiou 2018
Ghobara 2017
Glujovsky 2010
Glujovsky 2014
Glujovsky 2016
Gutarra‐Vilchez 2014
Huang 2013
Johnson 2010
Kalampokas 2017
Kamath 2017
-
- Kamath MS, Maheshwari A, Bhattacharya S, Lor KY, Gibreel A. Oral medications including clomiphene citrate or aromatase inhibitors with gonadotropins for controlled ovarian stimulation in women undergoing in vitro fertilisation. Cochrane Database of Systematic Reviews 2017, Issue 11. [DOI: 10.1002/14651858.CD008528.pub3] - DOI - PMC - PubMed
Kroon 2012
Kwan 2014
Kwan 2018
Lensen 2018
-
- Lensen SF, Wilkinson J, Leijdekkers JA, Marca A, Mol BWJ, Marjoribanks J, et al. Individualised gonadotropin dose selection using markers of ovarian reserve for women undergoing in vitro fertilisation plus intracytoplasmic sperm injection (IVF/ICSI). Cochrane Database of Systematic Reviews 2018, Issue 2. [DOI: 10.1002/14651858.CD012693.pub2] - DOI - PMC - PubMed
Martins 2013
McDonnell 2014
McDowell 2014
Mochtar 2017
Nagels 2015
Nastri 2015
Pandian 2010
Pandian 2013
Pandian 2015
Pouwer 2015
Proctor 2008
Reavey 2016
Sallam 2006
Showell 2014
Showell 2017
Siristatidis 2009
Siristatidis 2015
Siristatidis 2016
Siristatidis 2018
Tang 2016
Teixeira 2013
Tso 2014
Twisk 2006
-
- Twisk M, Mastenbroek S, Wely M, Heineman MJ, Veen F, Repping S. Preimplantation genetic screening for abnormal number of chromosomes (aneuploidies) in in vitro fertilisation or intracytoplasmic sperm injection. Cochrane Database of Systematic Reviews 2006, Issue 1. [DOI: 10.1002/14651858.CD005291.pub2] - DOI - PubMed
van der Linden 2015
Van Rumste 2003
van Wely 2011
Wong 2017
Yossry 2006
Youssef 2014
-
- Youssef MAFM, Veen F, Al‐Inany HG, Mochtar MH, Griesinger G, Nagi Mohesen M, et al. Gonadotropin‐releasing hormone agonist versus HCG for oocyte triggering in antagonist‐assisted reproductive technology. Cochrane Database of Systematic Reviews 2014, Issue 10. [DOI: 10.1002/14651858.CD008046.pub4] - DOI - PMC - PubMed
Youssef 2015
Youssef 2016
Additional references
Abou‐Setta 2006
-
- Abou‐Setta AM, Al‐Inany HG, Hornstein MD, Richard‐Davis G, Veen F, Poel N. Soft versus firm embryo transfer catheters for assisted reproductive technology. Cochrane Database of Systematic Reviews 2006, Issue 1. [DOI: 10.1002/14651858.CD005636] - DOI
Baak 2016
Benschop 2012
-
- Benschop L, Seshadri S, Toulis KA, Vincent K, Child T, Granne IE, Goulis DG. Immune therapies for women with history of failed implantation undergoing IVF treatment. Cochrane Database of Systematic Reviews 2012, Issue 1. [DOI: 10.1002/14651858.CD009602] - DOI
Boivin 2007
-
- Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment‐seeking: potential need and demand for infertility medical care. Human Reproduction 2007;22(6):1506‐12. - PubMed
Checa 2016
Chua 2012
-
- Chua W, Boothroyd C, Walls M, Hart RJ. Slow freeze versus vitrification for embryo cryopreservation. Cochrane Database of Systematic Reviews 2012, Issue 1. [DOI: 10.1002/14651858.CD009589] - DOI
Craciunas 2016a
ElDaly 2006
-
- ElDaly AA, Al‐Fozan HM, Al‐Inany HG, Bedaiwy MA, Saleh WF. Aromatase inhibitors for ovulation induction. Cochrane Database of Systematic Reviews 2015, Issue 3. [DOI: 10.1002/14651858.CD005635.pub2] - DOI
Higgins 2011
-
- Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). Available from www.cochrane‐handbook.org., 2011.
Jones 2012
Kamath 2017a
Nastri 2013
-
- Nastri CO, Teixeira DM, Moroni RM, Navarro PA, Ferriani RA, Martins WP. Interventions for improving reproductive outcomes in women with recurrent implantation failure undergoing assisted reproductive techniques. Cochrane Database of Systematic Reviews 2013, Issue 10. [DOI: 10.1002/14651858.CD010795] - DOI
NICE 2013
-
- National Institute for Health and Clinical Excellence. Fertility: assessment and treatment for people with fertility problems. London: National Institute for Health and Care Excellence, 2013.
Nyachieo 2009
Shea 2007
Zegers‐Hochschild 2009
-
- Zegers‐Hochschild F, Adamson GD, Mouzon J, Ishihara O, Mansour R, Nygren K, et al. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology. Human Reproduction 2009;24:2683‐7. - PubMed
Zhu 2013
-
- Zhu X, Lim CED, Nagels HE. Acupuncture for female subfertility. Cochrane Database of Systematic Reviews 2013, Issue 3. [DOI: 10.1002/14651858.CD010462] - DOI
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