Use of outcomes-based data in reducing high-order multiple pregnancies: the role of age, diagnosis, and embryo score

Interval double transfer improves treatment success in patients with repeated IVF/ET failures

“…Loutardis et al found that if the second transfer was performed on day 5 as opposed to day 4, there was additional success in outcome (i.e., a 60% pregnancy rate). The success rates of our study group are comparable to those achieved in what is considered to be the 'optimal patient' [14,15], and considerably remote from the rates of success previously reported for patients with failed multiple cycles (i.e. 10-20%) [12].…”

Guidelines for the number of embryos to transfer following in vitro fertilization

“…Instead, decisions limiting the number of embryos transferred should be made according to the relevant probabilities of pregnancy and multifetal gestation [65,66]. Several studies have characterized determinants of pregnancy and embryo implantation potential, [59,[67][68][69][70][71] and others have generated prediction models to minimize HOM and twin gestations [72][73][74].…”

Embryo morphology score on day 3 is predictive of implantation and live birth rates

“…However, other studies also have shown that moderately fragmented embryos (grade II) implant with similar rates to higher quality (grade I) embryos, but highly fragmented embryos (grade III and grade IV) have significantly decreased implantation rates (8). Because of these discrepancies, several authors promote using a "combined" or "cumulative" embryo score based on combined cleavage states and morphologies of all embryos being transferred (12)(13)(14)(15)(16). Unfortunately, these combined or generalized transfer scores can underestimate the potential of a single higher quality embryo to implant.…”