{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T21:13:35Z","timestamp":1793222015865,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The increasing utilisation of <jats:italic>in vitro<\/jats:italic> fertilisation (IVF) has prompted significant interest in determining the optimal endometrial environment to increase pregnancy rates and minimise the obstetric complications associated with various embryo transfer strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine which cycle is associated with increased obstetric complications: fresh embryo transfer (FreshET), natural thaw (NatThawET) or artificial thaw (ArtThawET). Outcomes of interest included: hypertensive disorders of pregnancy (HDP), gestational diabetes (GD), pre\u2010term birth (PTB), post\u2010partum haemorrhage (PPH) and large for gestational age (LGA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A comprehensive search of MEDLINE, EMBASE, CENTRAL, and PUBMED was conducted from 1947 to May 17, 2022. Two independent reviewers carried out the screening, and data extraction for the following comparisons: ArtThawET vs NatThawET, ArtThawET vs FreshET, and NatThawET vs FreshET. Meta\u2010analysis was conducted using a fixed\u2010effect Mantel\u2013Haenszel model. The quality of the studies was assessed using GRADEpro.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 23 studies were included in this review. ArtThawET was associated with a significantly increased odds of HDP (odds ratio (OR) 1.76, confidence interval (CI) 1.66\u20131.86), PTB (OR 1.18, CI 1.13\u20131.23), PPH (OR 2.61, CI 2.3\u20132.97) and LGA (OR 1.11, CI 1.07\u20131.15), compared to NatThawET. ArtThawET was also associated with increased odds of HDP (OR 2.13, CI 1.89\u20132.4), PPH (OR 3.52, CI 3.06\u20134.04) and LGA (OR 2.12, CI 1.77\u20132.56), compared to FreshET. Furthermore, NatThawET demonstrated increased odds of HDP (OR 1.20, CI 1.11\u20131.29), PPH (OR 1.25, CI 1.14\u20131.38) and LGA (OR 1.85, CI 1.66\u20132.07) compared to FreshET.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When clinically feasible, ArtThawET should be avoided as a first\u2010line option for IVF to reduce the risk of obstetric complications. An adequately powered, multicentre randomised controlled trial is necessary to confirm these findings and investigate the underlying pathophysiology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13750","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T12:18:51Z","timestamp":1694607531000},"page":"104-113","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Assessing obstetric outcomes: A systematic review and <scp>meta\u2010analysis<\/scp> comparing fresh, artificial, and natural thaw embryo transfer cycles"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3497-6127","authenticated-orcid":false,"given":"Amy","family":"Field","sequence":"first","affiliation":[{"name":"University of Melbourne  Melbourne Victoria 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