Elective single blastocyst transfer reduces twin rates without compromising pregnancy rates.
ABSTRACT To compare IVF outcome in single versus two blastocyst transfer in good-prognosis patients.
Retrospective data analysis.
University-based IVF practice.
Assisted reproductive technology outcome was compared in 41 patients who underwent elective single blastocyst transfer and 66 patients who underwent two blastocyst transfer.
Implantation rates, clinical pregnancy rates, cumulative pregnancy rates, twin pregnancy rates.
Blastocyst cycles between January 2003 and August 2004 (n = 238) were reviewed. Criteria for elective single embryo transfer established by our clinic were applied retrospectively to blastocyst cycles. Patients who met the criteria were divided into two groups, those who underwent elective single embryo transfer (eSET) and those who underwent two embryo transfer (2ET). Patient and cycle characteristics were similar for both groups. There were no differences in implantation rate (76% vs. 66%) or pregnancy rate (76% vs. 79%) between the eSET and 2ET groups. There was a significant difference in the number of twin pregnancies (3.2% vs. 62%) in the eSET versus 2ET group. Cumulative pregnancy rates were found to be 83% for both groups.
Single blastocyst transfer can be performed in good-prognosis patients without compromising pregnancy rates. Twin pregnancy rates can be significantly reduced with eSET.
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ABSTRACT: This study aimed to evaluate the best day for embryo transfer in a prospective unrestricted randomized multicenter trial. Data were collected on a preformed Excel-sheet which contained random numbers from 1 to 5 for each subsequent patient as a preprogrammed day for embryo transfer. Information was requested on patient's age, indication for sterility treatment, stimulation protocol used, numbers of oocytes retrieved, fertilized oocytes, cryopreserved embryos, and cell stage of embryos transferred. A total of 329 embryo transfers were performed, resulting in 106 clinical pregnancies (32.2%). Pregnancy rates achieved were 20.0% on day 1, 30.4% on days 2 and 3, and 50.0% on days 4 and 5 (p = 0.03). Within the scope of the present randomized multicenter trial, embryo transfers performed on days 4 and 5 enhanced the pregnancy rate significantly, compared to those of days 1, 2, and 3.Journal of Assisted Reproduction and Genetics 03/2003; 20(2):91-4. · 1.82 Impact Factor
Article: Blastocyst freezing.[show abstract] [hide abstract]
ABSTRACT: Blastocyst are preimplantation embryos that have successfully passed the critical step of genomic activation and have so a high developmental potential, thus allowing to reduce the number of embryos transferred. Blastocyst culture and freezing have really started in IVF programs in the early nineties, when it was possible to obtain good blastocysts (essentially using coculture) on a large scale. Blastocysts freezing has been performed since the beginning using glycerol as cryoprotectant in slow protocols. The transition from coculture to sequential media has been a little bit delicate with a drop in the results. Few modifications including a change in the freezing curves and thawing at 37 degrees C have allowed to reach the same results with the two culture techniques. Vitrification with ethylene glycol (EG) has been proposed recently. However, the toxicity of the metabolites of EG for rat embryos has to be considered before moving to this technology on a large scale.European Journal of Obstetrics & Gynecology and Reproductive Biology 08/2004; 115 Suppl 1:S12-5. · 1.84 Impact Factor
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ABSTRACT: There is much variability and no consensus on the definition of the most relevant outcome parameter after assisted reproduction technology (ART). Descriptive reports, such as annual statistics from national registries on the success of ART programmes, should present treatment success in terms of live birth per ovarian stimulation started, as this is the most relevant information for patients and doctors alike. Addressing concerns about the high rate of multiple pregnancies, rescaling the outcome of ART in large programmes and national audits to the singleton, live birth, might trigger a global change of attitude towards elective single embryo transfer in addition to any legal restrictions imposed. For clinical studies, the outcome measure will depend on the hypothesis tested, and investigators should remain free to choose the appropriate primary outcome measure.Human Reproduction 07/2004; 19(6):1239-41. · 4.67 Impact Factor