One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients

Abstract

Objective It is known that the single embryo transfer (SET) is the best choice to reduce multiples and associated risks. The practice of cryopreserving all embryos for posterior transfer has been increasingly performed for in vitro fertilization (IVF) patients at the risk of ovarian hyperstimulation syndrome or preimplantation genetic testing for aneuploidy. However, its widespread practice is still controverse. The aim of this study was to evaluate how effective is the transfer of two sequential SET procedures compared with a double embryo transfer (DET) in freeze-only cycles. Methods This retrospective study reviewed 5,156 IVF cycles performed between 2011 and 2019, and 506 cycles using own oocytes and freeze-only policy with subsequent elective frozen-thawed embryo transfers (eFET) were selected for this study. Cycles having elective SET (eSET, n = 209) comprised our study group and as control group we included cycles performed with elective DET (eDET, n = 291). In the eSET group, 57 couples who had failed in the 1st eSET had a 2nd eFET, and the estimated cumulative ongoing pregnancy rate was calculated and compared with eDET. Results After the 1st eFET, the ongoing pregnancy rates were similar between groups (eSET: 35.4% versus eDET: 38.5%; p = 0.497), but the estimated cumulative ongoing pregnancy rate after a 2nd eFET in the eSET group (eSET + SET) was significantly higher (48.8%) than in the eDET group (p < 0.001). Additionally, the eSET + SET group had a 2.7% rate of multiple gestations, which is significantly lower than the eDET group, with a 30.4% rate (p < 0.001). Conclusion Our study showed the association of freeze-only strategy with until up to two consecutive frozen-thawed eSETs resulted in higher success rates than a frozen-thawed DET, while drastically reducing the rate of multiple pregnancies.

Implementation and Evaluation of Preimplantation Genetic Testing at Vilnius University Hospital Santaros Klinikos

“…Although we could not find data comparing outcomes between fresh and frozen cycles when PGT-SR or PGT-M was applied, it is known that time to a clinical pregnancy is likely to be shorter using fresh embryo transfer during conventional IVF/ICSI than in a ‘freeze all’ strategy ( 16 ). More than one or double embryo transfer (DET) demonstrates a superior pregnancy and live birth rate, however, it is associated with a significantly higher risk of multiple gestations and increased risk for maternal and neonatal morbidity ( 17 , 18 ). As it was noticed, a maximum number of embryos allowed by Law in Lithuania to transfer during one cycle is three.…”

Atuação da enfermagem durante a fertilização in vitro em casais homoafetivos

“…A fase inicial da FIV é realizada através do uso de Quando o óvulo já fertilizado é transferido para o útero da mulher através de um cateter 12 .…”

“…Alguns fatores podem dificultar e reduzir as chances de sucesso do procedimento como: miomatose, endométrio atrófico e adenomiose. Além de se levar em consideração a idade, fatores também como doenças crônicas devem ser relevantes na hora de escolher qual das parceiras irá engravidar 12 .…”