Summary of findings 1. Embryo culture supernatant injection compared to no intervention for subfertile women in assisted reproduction.
| Embryo culture supernatant injection compared to no intervention for subfertile women in assisted reproduction | ||||||
| Patient or population: Subfertile women undergoing assisted reproduction Setting: IVF Units Intervention: Embryo culture supernatant injection before embryo transfer Comparison: No intervention | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with no intervention | Risk with embryo culture supernatant | |||||
| Live birth/ongoing pregnancy | 419 per 1,000 | 419 per 1,000 (218 to 808) | OR 1.11 (0.73 to 1.7) | 340 (3 RCTs) | ⊕⊝⊝⊝ VERY LOW 1,2,3 | |
| Miscarriage | 88 per 1,000 | 102 per 1,000 (29 to 303) | OR 0.89 (0.44 to 1.78) | 430 (4 RCTs) | ⊕⊝⊝⊝ VERY LOW 1,2,3 | |
| Clinical pregnancy | 513 per 1,000 | 544 per 1,000 (462 to 636) | OR 1.13 (0.80 to 1.61) | 526 (5 RCTs) | ⊕⊝⊝⊝ VERY LOW1,2,3 | |
| Ectopic pregnancy | 8 per 1,000 | 3 per 1,000 (0 to 61) | OR 0.32 (0.01 to 8.24) | 250 (2 RCTs) | ⊕⊝⊝⊝ VERY LOW1,2,3 | |
| Multiple pregnancy | 147 per 1,000 | 107 per 1,000 (43 to 239) | OR 0.70 (0.26 to 1.83) | 150 (2 RCTs) | ⊕⊝⊝⊝ VERY LOW1,2,3 | |
| Preterm delivery | 133 per 1,000 | 88 per 1,000 (25 to 271) | OR 0.63 (0.17 to 2.42) | 90 (1 RCT) | ⊕⊝⊝⊝ VERY LOW2,4 | |
| Foetal abnormalities | 0 per 1,000 | 0 per 1,000 (0 to 0) | OR 3.10 (0.12 to 79.23) | 60 (1 RCT) | ⊕⊕⊕⊝ LOW4 | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds ratio | ||||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
1Downgraded one level for imprecision; wide CIs and low number of events. 2 Downgraded one level due to studies at high risk of bias and unclear risk of publication bias 3 Downgraded one level due to high heterogeneity 4Downgraded two levels for imprecision; wide CIs and low number of events.