Pregnancy and birth outcomes of single versus multiple embryo transfer in gestational surrogacy arrangements: a systematic review and meta-analysis.

Attawet, J; Wang, AY; Farquhar, CM; Jordan, V; Li, Z; Sullivan, EA

Pregnancy and birth outcomes of single versus multiple embryo transfer in gestational surrogacy arrangements: a systematic review and meta-analysis.

Attawet, J

Wang, AY Farquhar, CM Jordan, V Li, Z

Sullivan, EA

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Publisher:: TAYLOR & FRANCIS LTD
Publication Type:: Journal Article
Citation:: Human fertility (Cambridge, England), 2021, pp. 1-11
Issue Date:: 2021-01-01

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Field	Value	Language
dc.contributor.author	Attawet, J https://orcid.org/0000-0001-7683-2290
dc.contributor.author	Wang, AY
dc.contributor.author	Farquhar, CM
dc.contributor.author	Jordan, V
dc.contributor.author	Li, Z https://orcid.org/0000-0002-7622-150X
dc.contributor.author	Sullivan, EA
dc.date.accessioned	2021-12-14T04:06:42Z
dc.date.available	2021-12-14T04:06:42Z
dc.date.issued	2021-01-01
dc.identifier.citation	Human fertility (Cambridge, England), 2021, pp. 1-11
dc.identifier.issn	1464-7273
dc.identifier.issn	1742-8149
dc.identifier.uri	http://hdl.handle.net/10453/152317
dc.description.abstract	Multiple embryo transfer (MET) is associated with both an increased risk of multiple pregnancy and of live birth. In recent years, MET has become standard practice for most surrogacy arrangements. There is limited review of the use of MET versus single embryo transfer (SET) in surrogacy practice. The present review systematically evaluated the pregnancy outcomes of surrogacy arrangements between MET versus SET among gestational carriers. A systematic search of five computerized databases without restriction to the English language or study type was conducted to evaluate the primary outcomes: (i) clinical pregnancy; (ii) live delivery; and (iii) multiple delivery rates. The search returned 97 articles, five of which met the inclusion criteria. The results showed that clinical pregnancy (RR = 1.21, 95% CI: 1.06-1.39, n = 5, I2 = 41%), live delivery (RR = 1.29, 95% CI: 1.10-1.51, n = 4, I2 = 35%) and multiple delivery rates (RR = 1.42, 95% CI: 6.58-69.73, n = 4, I2 = 54%) were statistically significantly different in MET compared to SET. Adverse events including miscarriage, preterm birth and low birthweight were found following MET. Our findings support the existing evidence that MET results in multiple pregnancy and subsequently more adverse outcomes compared to SET. From a public health perspective, SET should be advocated as the preferred treatment for gestational carriers.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	TAYLOR & FRANCIS LTD
dc.relation.ispartof	Human fertility (Cambridge, England)
dc.relation.isbasedon	10.1080/14647273.2020.1785643
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1114 Paediatrics and Reproductive Medicine
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.title	Pregnancy and birth outcomes of single versus multiple embryo transfer in gestational surrogacy arrangements: a systematic review and meta-analysis.
dc.type	Journal Article
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1114 Paediatrics and Reproductive Medicine
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2021-12-14T04:06:40Z
pubs.publication-status	Published

Abstract:

Multiple embryo transfer (MET) is associated with both an increased risk of multiple pregnancy and of live birth. In recent years, MET has become standard practice for most surrogacy arrangements. There is limited review of the use of MET versus single embryo transfer (SET) in surrogacy practice. The present review systematically evaluated the pregnancy outcomes of surrogacy arrangements between MET versus SET among gestational carriers. A systematic search of five computerized databases without restriction to the English language or study type was conducted to evaluate the primary outcomes: (i) clinical pregnancy; (ii) live delivery; and (iii) multiple delivery rates. The search returned 97 articles, five of which met the inclusion criteria. The results showed that clinical pregnancy (RR = 1.21, 95% CI: 1.06-1.39, n = 5, I2 = 41%), live delivery (RR = 1.29, 95% CI: 1.10-1.51, n = 4, I2 = 35%) and multiple delivery rates (RR = 1.42, 95% CI: 6.58-69.73, n = 4, I2 = 54%) were statistically significantly different in MET compared to SET. Adverse events including miscarriage, preterm birth and low birthweight were found following MET. Our findings support the existing evidence that MET results in multiple pregnancy and subsequently more adverse outcomes compared to SET. From a public health perspective, SET should be advocated as the preferred treatment for gestational carriers.

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http://hdl.handle.net/10453/152317