Abstract:
OBJECTIVE:To compare the effectiveness of elective single embryo transfer versus double embryo transfer on the outcomes of live birth, multiple live birth, miscarriage, preterm birth, term singleton birth, and low birth weight after fresh embryo transfer, and on the outcomes of cumulative live birth and multiple live birth after fresh and frozen embryo transfers. DESIGN:One stage meta-analysis of individual patient data. DATA SOURCES:A systematic review of English and non-English articles from Medline, Embase, and the Cochrane Central Register of Controlled Trials (up to 2008). Additional studies were identified by contact with clinical experts and searches of bibliographies of all relevant primary articles. Search terms included embryo transfer, randomised controlled trial, controlled clinical trial, single embryo transfer, and double embryo transfer. Review methods Comparisons of the clinical effectiveness of cleavage stage (day 2 or 3) elective single versus double embryo transfer after fresh or frozen in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatments were included. Trials were included if the intervention differed only in terms of the intended number of embryos to be transferred. Trials that involved only blastocyst (day five) transfers were excluded. RESULTS:Individual patient data were received for every patient recruited to all eight eligible trials (n=1367). A total of 683 and 684 women randomised to the single and double embryo transfer arms, respectively, were included in the analysis. Baseline characteristics in the two groups were comparable. The overall live birth rate in a fresh IVF cycle was lower after single (181/683, 27%) than double embryo transfer (285/683, 42%) (adjusted odds ratio 0.50, 95% confidence interval 0.39 to 0.63), as was the multiple birth rate (3/181 (2%) v 84/285 (29%)) (0.04, 0.01 to 0.12). An additional frozen single embryo transfer, however, resulted in a cumulative live birth rate not significantly lower than the rate after one fresh double embryo transfer (132/350 (38%) v 149/353 (42%) (0.85, 0.62 to 1.15), with a minimal cumulative risk of multiple birth (1/132 (1%) v 47/149 (32%)). The odds of a term singleton birth (that is, over 37 weeks) after elective single embryo transfer was almost five times higher than the odds after double embryo transfer (4.93, 2.98 to 8.18). CONCLUSIONS:Elective single embryo transfer results in a higher chance of delivering a term singleton live birth compared with double embryo transfer. Although this strategy yields a lower pregnancy rate than a double embryo transfer in a fresh IVF cycle, this difference is almost completely overcome by an additional frozen single embryo transfer cycle. The multiple pregnancy rate after elective single embryo transfer is comparable with that observed in spontaneous pregnancies.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
McLernon DJ,Harrild K,Bergh C,Davies MJ,de Neubourg D,Dumoulin JC,Gerris J,Kremer JA,Martikainen H,Mol BW,Norman RJ,Thurin-Kjellberg A,Tiitinen A,van Montfoort AP,van Peperstraten AM,Van Royen E,Bhattacharya Sdoi
10.1136/bmj.c6945subject
Has Abstractpub_date
2010-12-21 00:00:00pages
c6945eissn
0959-8138issn
1756-1833journal_volume
341pub_type
杂志文章,meta分析,评审abstract:OBJECTIVE:To determine the prevalence of severe psychological trauma --that is, post-traumatic stress disorder--in children involved in everyday road traffic accidents. DESIGN:12 month prospective study. SETTING:Accident and emergency department, Royal United Hospital, Bath. SUBJECTS:119 children aged 5-18 years inv...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7173.1619
更新日期:1998-12-12 00:00:00
abstract::The studySheppard JP, Stevens S, Stevens R, Martin U, Mant J, Hobbs R, McManus R. Benefits and harms of antihypertensive treatment in low-risk patients with mild hypertension.Published on 1 December 2018 JAMA Intern Med 2018;178:1626-34.This project was funded by a grant from the National Institute for Health Research...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l571
更新日期:2019-02-15 00:00:00
abstract:OBJECTIVE:To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. DESIGN:Multicentre randomised controlled trial. SETTING:Nine memory clinics and 159 general practitioners in the Netherlands. PARTICIPANTS:175 patients with a ne...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.e3086
更新日期:2012-05-15 00:00:00
abstract:OBJECTIVE:To examine changes in primary care in London in the 11 years since the Acheson report on primary health care in inner London. DESIGN:Analysis of key data from the family health services authority performance indicators and from the Department of Health; study of trends since the time of the Acheson report; e...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6862.1130
更新日期:1992-11-07 00:00:00
abstract:OBJECTIVES:To compare the effectiveness of an early switch to oral antibiotics with the standard 7 day course of intravenous antibiotics in severe community acquired pneumonia. DESIGN:Multicentre randomised controlled trial. SETTING:Five teaching hospitals and 2 university medical centres in the Netherlands. PARTICI...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38993.560984.BE
更新日期:2006-12-09 00:00:00
abstract:OBJECTIVES:To determine whether informed consent introduces selection bias in prospective observational studies using data from medical records, and consent rates for such studies. DESIGN:Systematic review. DATA SOURCES:Embase, Medline, and the Cochrane Library up to March 2008, reference lists from pertinent article...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.b866
更新日期:2009-03-12 00:00:00
abstract::Objective To analyse stage specific incidence of breast cancer in the Netherlands where women have been invited to biennial mammography screening since 1989 (ages 50-69) and 1997 (ages 70-75), and to assess changes in breast cancer mortality and quantified overdiagnosis.Design Population based study.Setting Mammograph...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j5224
更新日期:2017-12-05 00:00:00
abstract:OBJECTIVE:To determine whether diurnal variation occurs in the onset of stroke. DESIGN:Community based study over four years. SETTING:Oxfordshire, United Kingdom. SUBJECTS:105,000 people, of whom 675 had a first ever stroke. 545 had a cerebral infarction, 66 had primary intracerebral haemorrhage, 33 had subarachnoid...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6820.155
更新日期:1992-01-18 00:00:00
abstract:OBJECTIVES:To determine whether the dose of vitamin A currently recommended by the World Health Organization or half this dose gives better protection against childhood morbidity and mortality. DESIGN:Randomised study. SETTING:A combined oral polio vaccine and vitamin A supplementation campaign in Guinea-Bissau, Afri...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.38670.639340.55
更新日期:2005-12-17 00:00:00
abstract:OBJECTIVE:To evaluate the immunogenicity and reactogenicity of a new triple S recombinant hepatitis B vaccine in a cohort of healthy people in whom currently licensed hepatitis B vaccines had persistently not induced an immune response. DESIGN:Single centre, randomised, double blind, dose-response study. SETTING:Rese...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.314.7077.329
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVES:To review completed trials assessing effect of hormone replacement therapy on subsequent risk of stroke, assessing stroke by pathological type, severity, and outcome. DESIGN:Systematic review of randomised controlled trials identified from the Cochrane Library, Embase, and Medline; reviews; and reference li...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.38331.655347.8F
更新日期:2005-02-12 00:00:00
abstract:OBJECTIVE:To assess whether a late evening meal would improve nitrogen balance in patients with cirrhosis of the liver. DESIGN:Randomised crossover study of meal schedules comparing three meals a day with four or six meals a day, the four and six meal schedules both including a late evening meal (2300). SETTING:Metab...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.299.6709.1202
更新日期:1989-11-11 00:00:00
abstract::The recent growth in the numbers of published systematic reviews reflects growing recognition of their importance for improving knowledge about the effects of health care. In Britain the NHS R&D Programme has established two centres to prepare systematic reviews of existing information, and the Cochrane Collaboration-...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.309.6958.862
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of interventions designed to improve outcomes in patients with multimorbidity in primary care and community settings. DESIGN:Systematic review. DATA SOURCES:Medline, Embase, CINAHL, CAB Health, Cochrane central register of controlled trials, the database of abstracts of review...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.e5205
更新日期:2012-09-03 00:00:00
abstract:OBJECTIVES:To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. DESIGN:Community based prospective cohort study; nested age and sex matched case-control study. SET...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e1442
更新日期:2012-03-12 00:00:00
abstract:OBJECTIVES:To compare patients' preference for transdermal fentanyl or sustained release oral morphine, their level of pain control, and their quality of life after treatment. DESIGN:Randomised, multicentre, international, open label, crossover trial. SETTING:35 centres in Belgium, Canada, Denmark, Finland, the Unite...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.322.7295.1154
更新日期:2001-05-12 00:00:00
abstract:OBJECTIVE:To encourage active participation of Leicestershire general practitioners and their staff in audit; to examine the use of vitamin B-12 injections and to achieve a more appropriate use. DESIGN:Implementation of an agreed audit protocol, with central analysis and feedback of anonymous and aggregated data by a ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.6996.28
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVES:To evaluate the long term effects of perioperative beta blockade on mortality and cardiac morbidity in patients with diabetes undergoing major non-cardiac surgery. DESIGN:Randomised placebo controlled and blinded multicentre trial. Analyses were by intention to treat. SETTING:University anaesthesia and sur...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.332.7556.1482
更新日期:2006-06-24 00:00:00
abstract:OBJECTIVE:To investigate the impact of coexistent psychiatric morbidity on risk of suicide after a suicide attempt. DESIGN:Cohort study with follow-up for 21-31 years. SETTING:Swedish national register based study. PARTICIPANTS:39 685 people (53% women) admitted to hospital for attempted suicide during 1973-82. MAI...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.a2205
更新日期:2008-11-18 00:00:00
abstract::The studyA Rodger, V Cambiano, T Bruun, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet 2019;393:2428-38.This project was funde...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.l4915
更新日期:2019-08-27 00:00:00
abstract:OBJECTIVE:To describe the complete range of factors which doctors recognise as changing their clinical practice and provide a measure of how often education is involved in change. DESIGN:Interviews using the critical incident technique. SETTING:Primary and secondary care. SUBJECTS:Random sample of 50 general practit...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7084.870
更新日期:1997-03-22 00:00:00
abstract:OBJECTIVES:To study prospectively the differences in health inequality in men and women from 1986-96 using the Office for National Statistics' longitudinal study and new socioeconomic classification. To assess the relative importance of social class (based on employment characteristics) and social position according to...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.320.7245.1303
更新日期:2000-05-13 00:00:00
abstract:OBJECTIVE:To identify the nature and extent of any vocational training deficit within the London initiative zone and investigate the reasons. DESIGN:Collation of statistics and postal questionnaire surveys. SETTING:Thames regions inside and outside the London initiative zone. SUBJECTS:General practice registrars, tr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7023.97
更新日期:1996-01-13 00:00:00
abstract:OBJECTIVE:To document the relative importance of endogenous sex steroids in modulating the frequency of orgasms, the dominant aspect of sexual behaviour in healthy eugonadal men. DESIGN:Measurement of adrenal and testicular sex steroids in a sample of army recruits and study of their relation to frequency of orgasms a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6990.1289
更新日期:1995-05-20 00:00:00
abstract:OBJECTIVE:To systematically review and describe currently available approaches to supporting maintenance of weight loss in obese adults and to assess the evidence for the effectiveness of these interventions. DESIGN:Systematic review with meta-analysis. DATA SOURCES:Medline, PsycINFO, Embase, and the Cochrane Central...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.g2646
更新日期:2014-05-14 00:00:00
abstract:OBJECTIVES:To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. DESIGN:A consecutive case study of remand prisoners screened at reception for substanc...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7099.18
更新日期:1997-07-05 00:00:00
abstract:OBJECTIVES:To provide a contemporary account of the treatment and outcomes of acute coronary attacks in England and Wales and to identify strategies that might improve the outcome. DESIGN:Two year community and hospital based study in three British health districts. SETTING:Health districts of Brighton (population 28...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:
更新日期:1998-04-04 00:00:00
abstract::Care in the community for insane people today is more a matter of expert provision than communal support. In consequence, although they are no longer confined to hospital, mentally ill people largely remain marginalised in a society that does not have the resources, nor often the inclination, to take responsibility fo...
journal_title:BMJ (Clinical research ed.)
pub_type: 历史文章,杂志文章
doi:10.1136/bmj.311.7021.1708
更新日期:1995-12-23 00:00:00
abstract:OBJECTIVE:To assess the effect of disclosing authors' conflict of interest declarations to peer reviewers at a medical journal. DESIGN:Randomized controlled trial. SETTING:Manuscript review process at the Annals of Emergency Medicine. PARTICIPANTS: Reviewers (n=838) who reviewed manuscripts submitted between 2 June 2...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.l5896
更新日期:2019-11-06 00:00:00
abstract:OBJECTIVES:To identify factors that differentiate between effective and ineffective computerised clinical decision support systems in terms of improvements in the process of care or in patient outcomes. DESIGN:Meta-regression analysis of randomised controlled trials. DATA SOURCES:A database of features and effects of...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.f657
更新日期:2013-02-14 00:00:00