Elective transfer of single fresh blastocysts and later transfer of cryostored blastocysts reduces the twin pregnancy rate and can improve the in vitro fertilization live birth rate in younger women

Purpose: To investigate the outcome of IVF following intracytoplasmic sperm injection (ICSI) from ejaculate, percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE), with subsequent blastocyst culture and single blastocyst transfer.Methods: Single blastocyst transfer was performed after ejaculate ICSI (oligozoospermia) in 587 patients, TESE/ PESA (azoospermia) in 31 patients, and standard IVF in 680 women.Results: There were only minor differences in IVF characteristics between the standard IVF and the PESA-TESE couples. Couples where ejaculate ICSI were performed seemed to represent a slightly poorer prognostic group. A viable fetus after the 12th gestational week, i.e. ongoing pregnancy, was present in 41.4% after ICSI/ET, 51.6% after PESA-TESE/ET and in 40.4% after standard IVF/ET (no significant differences).Conclusion: Single blastocyst transfer after ejaculate ICSI or after PESA/TESE appears to give similar results as conventional IVF blastocyst culture.

Section: Discussionmentioning

confidence: 84%

Single blastocyst transfer after ICSI from ejaculate spermatozoa, percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE)

Nilsson

Waldenström

Engström

et al. 2007

“…However it has been reported that, even though eSET elevates the chance of delivering a healthy baby compared to double embryo transfer (DET) in cleavage stage embryo [7], eSET results in significantly decreased pregnancy and delivery rates per embryo transfer [8,9]. In contrast to these results, it has been reported that the clinical outcomes of elective single blastocyst embryo transfer (eSBET) are similar to those of double blastocyst embryo transfer (DBET) on day 5 [10]. Also, some studies have shown that eSBET results in significantly higher pregnancy and delivery rates compared to day 2 or 3 elective single cleavage embryo transfer (eSCET) in selected groups [11][12][13].…”

Section: Introductionmentioning

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

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.

“…Extending culture to day 5/6 has been advocated to identify developmentally competent embryos for transfer or cryopreservation [4,5]. This approach should make possible the transfer of a single blastocyst, thereby maintaining high pregnancy rates while controlling the incidence of multiple gestations [6][7][8]. The integration of Values are means ± SD TQE top quality embryo blastocyst culture for all patients might virtually eliminate the incidence of high-order multiple pregnancies due to decrease in the number of embryos transferred [24].…”

Section: Discussionmentioning

confidence: 99%

“…The use of sequential media has demonstrated that extended embryo culture to the blastocyst stage enhances the likelihood of pregnancy [3][4][5]. Some studies have recently reported high pregnancy rates after single blastocyst transfer (SBT) on day 5 in selected couples [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Top quality embryos at day 2: a prerequisite for single blastocyst transfer? An observational cohort study in women under 36

Guérif

Lemseffer

Blanchard

et al. 2009

Purpose While extended culture has been considerably improved, some questions remain regarding the application of Single Blastocyst Transfer (SBT). Methods An observational cohort study was undertaken with 456 women under 36 years old and assigned to SBT on a voluntary basis. The main outcome was the cumulative delivery rate per couple according to the number of Top Quality Embryos (TQE) on day 2 (Group 1= ≥2 TQE, Group 2= 1 TQE and Group 3= 0 TQE). Results Rate of transfer and mean number of frozen blastocyts were higher in Group 1 compared to Group 3. As a consequence, the cumulative delivery rate per couple was higher in Group 1 (47.9%) compared to Group 3 (34.9%). Conclusions Single blastocyst transfer combining fresh and frozen cycles, might be a worthwhile strategy irrespective of embryo quality on day 2 providing good delivery rates while keeping the rate of multiple deliveries low.