Selected single blastocyst transfers maintained pregnancy outcome and eliminated multiple pregnancies

Abstract

Transfer of more than one embryo following fertilization/intracytoplasmic sperm injection cycles have increased pregnancy rate at the cost of increasing the incidence of triplets and twins. It has been proposed that prolonged culture to the blastocyst stage would automatically result in the selection of good quality embryos for transfer and minimize the incidence of triplets and twins. The objectives of the present retrospective analysis were to examine the pregnancy outcome, multiple pregnancy and related data following: (i) single blastocyst transfer (BT) and double BT; (ii) single BT in patients belonging to different age groups; and (iii) good, fair or poor quality of BT. A total of 260 BT were carried out between August 1998 and July 2002 and they are included in the current study. Sixty of the 260 BT patients received a single BT, and 41 of them received selected single good quality BT (SSBT). The implantation rate has no significant difference between following single BT (53.3%) and double BT (42.8%). No multiple pregnancy occurred following single BT, while significantly higher ( < 0.05) multiple pregnancy rate was observed following a double BT (45.8%). The clinical pregnancy and implantation rates following a single BT were similar ( > 0.05) in patients belonging to <30 years (62.5%), 30-34 years (57.9%) and 35-39 years old (35.8%). Selected single good quality BT maintained pregnancy and avoided multiple pregnancies. It is recommended for patients with a risk for high-order multiple pregnancy. (Reprod Med Biol 2004;: 13-18).

Pregnancy rate, multiple pregnancy rate, and embryo quality: Clues for single blastocyst transfer from double blastocyst transfer in an unselected population

“…In this series, pregnancy rate, implantation rate, and multiple pregnancy rate were lower in patients over 35 years old than in those below 34, although the difference between two age groups was not significant. The result was similar to that reported by Kuramoto et al 9 . Multiple pregnancy was not seen in patients over 36 years old.…”

“…Feasibility of elective single embryo transfer in cleavage‐stage embryos (eSET) initially was demonstrated retrospectively after judging the quality of embryos transferred in double embryo transfer (DET) procedures. The answer to the question of what grade of blastocyst represents a putative high competence (PHC) embryo is an unresolved question, although many studies have reported that blastocyst transfer offers a higher implantation rate than transfer of cleavage‐stage embryos 8–16 . Most blastocyst transfer programs are intended for selected groups of patients, so even randomized controlled studies involve self‐selection bias 8 …”

Effect on clinical and neonatal outcomes of blastocelic microsuction prior to vitrification

“…In contrast to early‐stage embryos, blastocysts represent more mature, naturally selected embryos with a higher potential for development and implantation after in vitro fertilization (IVF) . From the viewpoint of vitrified blastocyst transfer programs, assisted reproductive technology requires that blastocysts be completely vitrified to enhance the IVF success rate . However, Vanderzwalmen et al found that the survival rate after vitrification/warming depended on the stage of blastocyst development, with expanded blastocysts exhibiting lower survival rate than morulae or early cavitating blastocysts.…”

Perinatal outcome of twice-frozen-thawed embryo transfers: a clinical follow-up study

“…Oocytes were retrieved under transvaginal ultrasound guidance 34 to 35 hours after hCG injection and subjected to conventional IVF-ICSI procedures (day 0) (17). After insemination, oocytes were cultured individually in 20-mL droplets of BlastAssist System medium (Origio, Jyllinge, Denmark) or Sydney IVF sequential medium (Cook, Brisbane, Australia) at 37 C in a humidified atmosphere of 6% CO 2 , 5% O 2 , and 89% N 2 .…”