L Leniaud1, C Poncelet2, R Porcher3, B Martin-Pont1, I Cédrin-Durnerin2, J-N Hugues2, J-P Wolf1, C Sifer4. 1. Service d'histologie-embryologie-cytogénétique, laboratoire de biologie de la reproduction, CHU Jean-Verdier, Assistance publique-Hôpitaux de Paris (AP-HP), avenue du 14-Juillet, 93140 Bondy, France. 2. Pôle femmes et enfants, CHU Jean-Verdier, Assistance publique-Hôpitaux de Paris (AP-HP), 93140 Bondy, France. 3. Service de biostatistiques, CHU Saint-Louis, Assistance publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France. 4. Service d'histologie-embryologie-cytogénétique, laboratoire de biologie de la reproduction, CHU Jean-Verdier, Assistance publique-Hôpitaux de Paris (AP-HP), avenue du 14-Juillet, 93140 Bondy, France. Electronic address: christophe.sifer@jvr.aphp.fr.
Abstract
OBJECTIVE: Multiple embryo transfer is responsible for a high rate of multiple pregnancies (ICSI), with subsequent risks of premature birth and perinatal death. This prospective non randomized study aimed to assess the ability of an elective single-embryo transfer (eSET) policy to reduce the twin pregnancy rate, compared to a double embryo transfer (DET) approach. PATIENTS AND METHODS: Between March 2005 and May 2006, 180 eligible women were proposed to benefit from an eSET transfer rather than a DET. Inclusion criteria were (i) age less than 37 years old; (ii) at least two good quality embryos available (three to five cells at day 2 or six to nine cells at day 3; less than 20% fragmentation and the absence of multinucleates blastomeres), after IVF or ICSI and (iii) no more than one previous failed treatment cycle. Outcome analysis included cycles with frozen-thawed embryo transfer (FET). RESULTS: According to patients' decision, 107 and 73 women had an eSET (59.4%) and a DET (40.6%) respectively. No differences were found between eSET and DET groups regarding demographics and biologicals parameters. The clinical pregnancy rate (PR) per transfer was 43.9% in eSET group and 57.5% in DET group (p=0.07). The twin pregnancy rates were 0 and 14.3%, in eSET and DET groups, respectively (p=0.007). The cumulative PR per patient, including the outcome of performed FET cycles, was 63.6% in eSET group and 61.6% in DET group. In this case, the cumulative twin pregnancy rates were 2.9 and 15.6% in eSET and DET groups, respectively (p=0.02). DISCUSSION AND CONCLUSION: Our data show that in a selected population of women, transferring one fresh embryo and then, if required, one or two frozen-thawed embryos significantly reduces the twin pregnancy rate without decreasing the overall pregnancy rate. This study supports the policy of eSET in this subgroup of patients.
OBJECTIVE: Multiple embryo transfer is responsible for a high rate of multiple pregnancies (ICSI), with subsequent risks of premature birth and perinatal death. This prospective non randomized study aimed to assess the ability of an elective single-embryo transfer (eSET) policy to reduce the twin pregnancy rate, compared to a double embryo transfer (DET) approach. PATIENTS AND METHODS: Between March 2005 and May 2006, 180 eligible women were proposed to benefit from an eSET transfer rather than a DET. Inclusion criteria were (i) age less than 37 years old; (ii) at least two good quality embryos available (three to five cells at day 2 or six to nine cells at day 3; less than 20% fragmentation and the absence of multinucleates blastomeres), after IVF or ICSI and (iii) no more than one previous failed treatment cycle. Outcome analysis included cycles with frozen-thawed embryo transfer (FET). RESULTS: According to patients' decision, 107 and 73 women had an eSET (59.4%) and a DET (40.6%) respectively. No differences were found between eSET and DET groups regarding demographics and biologicals parameters. The clinical pregnancy rate (PR) per transfer was 43.9% in eSET group and 57.5% in DET group (p=0.07). The twin pregnancy rates were 0 and 14.3%, in eSET and DET groups, respectively (p=0.007). The cumulative PR per patient, including the outcome of performed FET cycles, was 63.6% in eSET group and 61.6% in DET group. In this case, the cumulative twin pregnancy rates were 2.9 and 15.6% in eSET and DET groups, respectively (p=0.02). DISCUSSION AND CONCLUSION: Our data show that in a selected population of women, transferring one fresh embryo and then, if required, one or two frozen-thawed embryos significantly reduces the twin pregnancy rate without decreasing the overall pregnancy rate. This study supports the policy of eSET in this subgroup of patients.
Authors: Zhihong Yang; Jiaen Liu; Gary S Collins; Shala A Salem; Xiaohong Liu; Sarah S Lyle; Alison C Peck; E Scott Sills; Rifaat D Salem Journal: Mol Cytogenet Date: 2012-05-02 Impact factor: 2.009
Authors: Andrea Weghofer; Katharina Klein; Maria Stammler-Safar; Christof Worda; David H Barad; Peter Husslein; Norbert Gleicher Journal: Reprod Biol Endocrinol Date: 2009-11-25 Impact factor: 5.211
Authors: Ricardo L R Baruffi; Ana L Mauri; Claudia G Petersen; Andréia Nicoletti; Anagloria Pontes; João Batista A Oliveira; José G Franco Journal: Reprod Biol Endocrinol Date: 2009-04-23 Impact factor: 5.211