好胚&差胚一起植入 vs 單一好胚植入 

懷孕率並無差異

但 好胚&差胚一起植入多胞胎機率會提高

Transfer of a poor-quality along with a good-quality embryo on in vitro fertilization/intracytoplasmic sperm injection-embryo transfer clinical outcomes: a systematic review and meta-analysis

 Fertil steril VOLUME 118, ISSUE 6, P1066-1079, DECEMBER 01, 2022

Objective

To investigate the effect on the pregnancy rate of transfer of a good-quality embryo (GQE) and a poor-quality embryo (PQE) in comparison with a single GQE transfer.

Patient(s)

Infertility patients undergoing in vitro fertilization/intracytoplasmic sperm injection- embryo transfer.

Intervention(s)

Three major electronic databases (PubMed, Embase, and Cochrane Library) for studies those compared single GQE transfer to double embryo transfer of a GQE + PQE were searched. The Newcastle–Ottawa Quality Assessment Scale was used to evaluate the study quality. Random-effect meta-analysis was performed on all data for an overall analysis, followed by a subgroup analysis (fresh cleavage-stage embryos, fresh blastocysts, frozen-thawed blastocysts, and the same assessment criteria for blastocyst quality).

Main Outcome Measure(s)

The primary outcome was clinical pregnancy rate (CPR).

Result(s)

A total of 17 studies with 17,612 cycles for GQE transfer and 6,431 cycles for GQE + PQE transfer were included in the meta-analysis. No significant differences were found in CPR (relative risk [RR] = 1.02; 95% confidence interval [CI], 0.91–1.14) and live birth rate (RR = 0.96; 95% CI, 0.87–1.07) between GQE + PQE and GQE transfers. However, the transfer of GQE + PQE increased multiple pregnancy rate (RR = 0.14; 95% CI, 0.09–0.20) and multiple birth rate (RR = 0.08; 95% CI, 0.06–0.12), when compared with the patients undergoing a single GQE transfer. Subgroup analyses by type of embryo for transfer and assessment criteria for embryo quality showed similar trends.

Conclusion(s)

Double embryo transfer with GQE + PQE does not result in increased or decreased CPR and live birth rate when compared with a single GQE transfer but leads to a higher multiple pregnancy rate and multiple birth rate.