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.