Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Apr 16;25(1):453.
doi: 10.1186/s12884-025-07511-5.

Optimal timing to transfer embryos for women who underwent hysteroscopy: a systematic review and meta-analysis

Chang Liu  1   2 , Zhiqi Liao  3 , Lei Cai  3 , Xueqi Gong  3 , Yanan Li  4 , Yunan He  5   6 , Yinwei Chen  7
Affiliations
Meta-Analysis

Optimal timing to transfer embryos for women who underwent hysteroscopy: a systematic review and meta-analysis

Chang Liu et al. BMC Pregnancy Childbirth. .

Abstract

Objective: This study aimed to investigate the optimal time interval between hysteroscopy and embryo transfer.

Methods: Electronic databases including PubMed, Embase, and Cochrane Library were searched up to Jul 2021. Two authors selected the articles independently and extracted data regarding study characteristics, quality, and results. A random-effect model was employed, and summary risk ratios (RR) at 95% confidence intervals (CI) were calculated.

Results: A total of 2123 patients from 5 studies were included. Pooled results showed that no significant differences for clinical pregnancy rates within 50-day and 90-day time interval comparison groups (RR = 0.83, 95% CI 0.61-1.11, P = 0.21; and RR = 0.91, 95% CI 0.74-1.12, P = 0.38, respectively), whereas clinical pregnancy rate was significantly increased in patients with a waiting interval of ≤ 120 days (RR = 0.75, 95% CI 0.61-0.93, P = 0.009). Subgroup analysis demonstrated that transferring embryos within 50 days for patients with normal uterine cavities was associated with a higher live birth rate (RR = 0.71, 95% CI 0.54-0.95, P = 0.02).

Conclusion: This meta-analysis identified that performing embryo transfer within 120 days for patients who underwent adhesiolysis and polypectomy within 50 days for patients who underwent diagnostic hysteroscopy was associated with superior outcomes, respectively. These findings may provide evidence to guide clinical decisions for reproductive clinicians. The conclusions might be limited by the small publication numbers. Further studies with a larger sample size were recommended.

Keywords: Assisted reproduction technique; Embryo transfer; Hysteroscopy; Pregnancy; Uterine cavity.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study identification and selection process for systematic review and meta-analysis
Fig. 2
Fig. 2
Data for primary and secondary outcomes according to time intervals, as provided by the included studies. Values in parentheses were percentages
Fig. 3
Fig. 3
Forest plots presenting the association of time interval between hysteroscopy and embryo transfer with clinical pregnancy rate. (A) Clinical pregnancy rates of patients who underwent embryo transfer ≤ 50 days versus > 50 days following hysteroscopy. (B) Clinical pregnancy rates of patients who underwent embryo transfer < 90 days versus ≥ 90 days following hysteroscopy. (C) Clinical pregnancy rates of patients who underwent embryo transfer ≤ 120 days versus > 120 days following hysteroscopy
Fig. 4
Fig. 4
Forest plots presenting the association of time interval between hysteroscopy and embryo transfer with live birth rate. (A) Live birth rates of patients who underwent embryo transfer ≤ 50 days versus > 50 days following hysteroscopy. (B) Live birth rates of patients who underwent embryo transfer < 90 days versus ≥ 90 days following hysteroscopy
Fig. 5
Fig. 5
Forest plots presenting the association of time interval between hysteroscopy and embryo transfer with miscarriage rate. (A) Miscarriage rates of patients who underwent embryo transfer < 90 days versus ≥ 90 days following hysteroscopy. (B) Miscarriage rates of patients who underwent embryo transfer ≤ 120 days versus > 120 days following hysteroscopy
Fig. 6
Fig. 6
Subgroup meta-analysis by indications for hysteroscopy of clinical pregnancy rate for patients who underwent embryo transfer (A) ≤ 50 days versus > 50 days or (B) ≤ 120 days versus > 120 days following hysteroscopy
Fig. 7
Fig. 7
Subgroup meta-analysis by indications for hysteroscopy of miscarriage rate for patients who underwent embryo transfer ≤ 120 days versus > 120 days, following hysteroscopy
Fig. 8
Fig. 8
Subgroup meta-analysis by indications for hysteroscopy of live birth rate for patients who underwent embryo transfer (A) ≤ 50 days versus > 50 days or (B) < 90 days versus ≥ 90 days following hysteroscopy
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Cevrioglu AS, Esinler I, Bozdag G, Yarali H. Assessment of endocervical and endometrial damage inflicted by embryo transfer trial: a hysteroscopic evaluation. Reprod Biomed Online. 2006;13(4):523–7. - PubMed
    1. Mansour R, Aboulghar M, Serour G. Dummy embryo transfer: a technique that minimizes the problems of embryo transfer and improves the pregnancy rate in human in vitro fertilization. Fertil Steril. 1990;54(4):678–81. - PubMed
    1. Fatemi HM, Popovic-Todorovic B. Implantation in assisted reproduction: a look at endometrial receptivity. Reprod Biomed Online. 2013;27(5):530–8. - PubMed
    1. Evans J, Salamonsen LA, Winship A, Menkhorst E, Nie G, Gargett CE, Dimitriadis E. Fertile ground: human endometrial programming and lessons in health and disease. Nat Rev Endocrinol. 2016;12(11):654–67. - PubMed
    1. Liu C, Yao W, Yao J, Li L, Yang L, Zhang H, Sui C. Endometrial extracellular vesicles from women with recurrent implantation failure attenuate the growth and invasion of embryos. Fertil Steril. 2020;114(2):416–25. - PubMed

LinkOut - more resources