Comparison of the pregnancy outcomes of natural conception with
PGD in RPL carriers
Few studies have comparied the pregnancy outcomes after choosing between
NC/EM (natural conception/expectant management) and PGD for RPL
carriers, because randomized control trials are unavailable. We
systemically searched the literature as much as possible for the
available evidence on pregnancy outcomes to describe this question and
only 2 nonrandomized comparative studies comparing the pregnancy
outcomes after PGD with those after NC in our study (Table 5). Savanie
reported that 74% of RPL carriers with NC and 38.5% of those with PGD
had a live birth, although the period of follow-up was significantly
longer in the NC group (p=0.016)[19]. Shinichiro reported 37-63% on
the first trial, 65-83% cumulatively with NC and 27-54% with PGD had
at least a live birth[18]. The meta-analysis showed no significant
difference in the accumulated LBR (Figure 3a; two studies; odds ratio
(OR): 1.82; 95% CI: 0.38–8.71; I2 =71%; p=0.45) but
a higher miscarriage rate (Figure 3b; two studies; odds ratio (OR):
5.75; 95% CI: 2.57–12.86; I2 =45%;
p<0.0001) when comparing NC with PGD in RPL carriers.