Blastocyst-stage embryo transfer in patients who failed to conceive in three or more day 2–3 embryo transfer cycles: a prospective, randomized study

Purpose To compare the clinical outcomes of elective single morula embryo transfer (eSMET) versus elective single blastocyst embryo transfer (eSBET) in selected patients. Methods This study was a retrospective study which analyzed for 271 cycles in women under 37 years of age who are undergoing their first or second trial of in vitro fertilization-embryo transfer (IVF-ET) from January 2008 to December 2009. The eSMET was performed on day 4 (n0130) and the eSBET was conducted on day 5 (n0141). Results The clinical pregnancy rate (51.5% vs. 51.8%, p0 0.97), implantation rate (52.3% vs. 52.5%, p00.98), and live birth rate (39.2% vs. 44.7%, p00.36) were similar in the eSMET and eSBET groups, respectively. The miscarriage rate of the eSMET group (23.9%) was slightly higher than that of the eSBET group (13.7%) (p00.12), without reaching statistical significance. There was only one case of monozygotic twin pregnancy in each group. ConclusionsThe clinical outcomes of day 4 eSMET were comparable to those of day 5 eSBET. Therefore, day 4 eSMET is a viable option or an alternative to day 5 eSBET, with no difference in success rates.

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of elective single morula embryo transfer versus elective single blastocyst embryo transfer in IVF-ET

Kang

Lee

Jeong

et al. 2012

“…In another study, the benefit of day 5 transfer in patients with implantation failure through day 2-3 embryo transfer cycles was evaluated in a prospective study [5]. Patients were randomly allocated either to another cleavage-stage embryo transfer or blastocyst transfer.…”

Section: Discussionmentioning

confidence: 99%

“…Embryological and/or endometrial factors may be responsible for such repeated failures and many strategies have been evaluated to improve results. Blastocyst transfer has been proposed as an approach after repeated IVF failures for its providing a better implantation rate in some studies [2][3][4] but some others did not demonstrate the beneficial effect of day 5 transfer in these patients [5,6].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the transfer of equal numbers of blastocysts versus cleavage-stage embryos after repeated failure of in vitro fertilization cycles

Karacan¹,

Ulug²,

Arvas³

et al. 2013

Purpose To evaluate the efficacy of blastocyst transfer in women with at least two previously unsuccessful in vitro fertilization-embryo transfer (IVF-ET) attempts. Methods Retrospective analysis of 238 couples (with previous implantation failures) had equal number (two) of cleavage-stage embryos (n =143) or blastocysts (n =95) transferred in the same IVF center.Results The clinical pregnancy rates and live-birth rates were similar in the cleavagestage embryo transfer group and the blastocyst group (35.6 % vs. 40 % and 32.1 % vs. 35.7 %; p >0.05, respectively). Miscarriage rates (9.8 % vs. 10.5 %) and multiple pregnancy rates (15.6 % vs. 23.6 %) did not differ. Although implantation rate was higher with blastocyst transfer than that with day 3 transfer, it did not reach to a statistical significance (24.7 % and 19 %, respectively, p >0.05). Conclusion Blastocyst transfer in ICSI cycles does not yield a better outcome than that obtained with cleavage-stage embryos in women who had unsuccessful IVF attempts previously.

“…Indeed, several studies have investigated the benefit of blastocyst transfer to women with RIF [27,44,56]. The study by Cruz et al [27], although not randomized, showed significantly increased pregnancy and implantation rates for women who underwent blastocyst transfer (N015), compared to those in which embryo transfer occurred on day 3 (N022)(40 % vs 9.1 % and 11.3 % vs 3.4 %, respectively).…”

Section: Blastocyst Culturementioning

confidence: 99%

Assessment and treatment of repeated implantation failure (RIF)

Simon

Laufer

2012

215

161

Repeated implantation failure (RIF) is determined when embryos of good quality fail to implant following several in vitro fertilization (IVF) treatment cycles. Implantation failure is related to either maternal factors or embryonic causes. Maternal factors include uterine anatomic abnormalities, thrombophilia, non-receptive endometrium and immunological factors. Failure of implantation due to embryonic causes is associated with either genetic abnormalities or other factors intrinsic to the embryo that impair its ability to develop in utero, to hatch and to implant. New methods of time-lapse imaging of embryos and assessment of their metabolic functions may improve selection of embryos for transfer, and subsequent outcomes for IVF patients, as well as for those diagnosed with RIF. This review discusses the various causes associated with RIF and addresses appropriate treatments.