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Meta-Analysis
. 2015 Oct 15;10(10):e0140779.
doi: 10.1371/journal.pone.0140779. eCollection 2015.

Can Comprehensive Chromosome Screening Technology Improve IVF/ICSI Outcomes? A Meta-Analysis

Minghao Chen  1 , Shiyou Wei  2 , Junyan Hu  3 , Song Quan  1
Affiliations
Meta-Analysis

Can Comprehensive Chromosome Screening Technology Improve IVF/ICSI Outcomes? A Meta-Analysis

Minghao Chen et al. PLoS One. .

Abstract

Objective: To examine whether comprehensive chromosome screening (CCS) for preimplantation genetic screening (PGS) has an effect on improving in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes compared to traditional morphological methods.

Methods: A literature search was conducted in PubMed, EMBASE, CNKI and ClinicalTrials.gov up to May 2015. Two reviewers independently evaluated titles and abstracts, extracted data and assessed quality. We included studies that compared the IVF/ICSI outcomes of CCS-based embryo selection with those of the traditional morphological method. Relative risk (RR) values with corresponding 95% confidence intervals (CIs) were calculated in RevMan 5.3, and subgroup analysis and Begg's test were used to assess heterogeneity and potential publication bias, respectively.

Results: Four RCTs and seven cohort studies were included. A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24). CCS-based PGS was also related to an increased clinical pregnancy rate (RCT RR 1.26, 95% CI 0.83-1.93; cohort study RR 1.48, 95% CI 1.20-1.83), an increased ongoing pregnancy rate (RCT RR 1.31, 95% CI 0.64-2.66; cohort study RR 1.61, 95% CI 1.30-2.00), and an increased live birth rate (RCT RR 1.26, 95% CI 1.05-1.50; cohort study RR 1.35, 95% CI 0.85-2.13) as well as a decreased miscarriage rate (RCT RR 0.53, 95% CI 0.24-1.15; cohort study RR 0.31, 95% CI 0.21-0.46) and a decreased multiple pregnancy rate (RCT RR 0.02, 95% CI 0.00-0.26; cohort study RR 0.19, 95% CI 0.07-0.51). The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.

Conclusions: The effectiveness of CCS-based PGS is comparable to that of traditional morphological methods, with better outcomes for women receiving IVF/ICSI technology. The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of search and selection strategy.
Fig 2
Fig 2. Forest plots showing the results of meta-analysis on implantation comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.
(a) Forest plot of pooled RR on implantation of RCTs; (b) Forest plot of pooled RR on implantation of cohort studies.
Fig 3
Fig 3. Forest plots showing the results of meta-analysis on clinical pregnancy comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.
(a) Forest plot of pooled RR on clinical pregnancy of RCTs; (b) Forest plot of pooled RR on clinical pregnancy of cohort studies.
Fig 4
Fig 4. Forest plots showing the results of meta-analysis on ongoing pregnancy comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.
(a) Forest plot of pooled RR on ongoing pregnancy of RCTs; (b) Forest plot of pooled RR on ongoing pregnancy of cohort studies.
Fig 5
Fig 5. Forest plots showing the results of meta-analysis on live birth comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.
(a) Forest plot of pooled RR on live birth of RCTs; (b) Forest plot of pooled RR on live birth of cohort studies.
Fig 6
Fig 6. Forest plots showing the results of meta-analysis on miscarriage comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.
(a) Forest plot of pooled RR on miscarriage of RCTs; (b) Forest plot of pooled RR on miscarriage of cohort studies.
Fig 7
Fig 7. Forest plots showing the results of meta-analysis on multiple pregnancy comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.
(a) Forest plot of pooled RR on multiple pregnancy of RCTs; (b) Forest plot of pooled RR on multiple pregnancy of cohort studies.
Fig 8
Fig 8. Begg’s funnel plot for assessment of publication bias, suggesting no significant small-study bias.
See this image and copyright information in PMC

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