The impact of atosiban on pregnancy outcomes in women undergoing in vitro fertilization-embryo transfer: A meta-analysis

Abstract

Background: Atosiban is administered to women undergoing in vitro fertilization-embryo transfer (IVF-ET) to improve pregnancy outcomes. However, the results of this treatment were controversial. We conducted this meta-analysis to investigate whether atosiban improves pregnancy outcomes in the women undergoing in vitro fertilization (IVF).

Methods: Databases of PubMed, EMBASE, Web of Science, China BioMedicine, and Google Scholar were systematically searched. Meta-analyses were performed to investigate whether atosiban improves pregnancy outcomes in the women undergoing IVF.

Results: Our results showed that atosiban was associated with higher implantation (OR = 1.63, 95% CI: 1.17-2.27; P = 0.004) and clinical pregnancy (OR = 1.84, 95% CI: 1.31-2.57; P < 0.001) rates. However, atosiban showed no significant association with the miscarriage, live birth, multiple pregnancy or ectopic pregnancy rates. When a further subgroup analysis was performed in the women undergoing repeated implantation failure (RIF), implantation (OR = 1.93, 95% CI: 1.45-2.57; P < 0.001), clinical pregnancy (OR = 2.48, 95% CI: 1.70-3.64; P <0.001) and the live birth (OR = 2.89, 95% CI: 1.78-4.67; P < 0.001) rates were significantly higher in the case group. Nevertheless, no significant difference was detected in the miscarriage and multiple pregnancy rates between the case and control groups.

Conclusion: Atosiban may be more appropriate for women undergoing RIF and play only a limited role in improving pregnancy outcomes in the general population of women undergoing IVF. These conclusions should be verified in large and well-designed studies.

Fig 1. Flowchart.

Fig 2. Forest plots for pregnancy outcomes in the women undergoing in vitro fertilization, including the implantation rate (a), clinical pregnancy rate (b), miscarriage rate (c), live birth rate (d), multiple pregnancy rate (e), clinical pregnancy rate (e), and ectopic pregnancy rate (f).

Fig 3. Forest plots for pregnancy outcomes in the women undergoing repeated implantation failure, including the implantation rate (a), clinical pregnancy rate (b), miscarriage rate (c), live birth rate (d), multiple pregnancy rate (e).

Fig 4. Begg’s funnel plot for publication bias of implantation rate (a), clinical pregnancy rate (b), miscarriage rate (c), live birth rate (d), multiple pregnancy rate (e), clinical pregnancy rate (e), and ectopic pregnancy rate (f) in the women undergoing in vitro fertilization.

Fig 5. Begg’s funnel plot for publication bias of the implantation rate (a), clinical pregnancy rate (b), miscarriage rate (c), live birth rate (d), multiple pregnancy rate (e) in the women undergoing repeated implantation failure.