Comparison of clinical outcomes of “single blastocyst” versus “double blastocyst” transfer in assisted reproductive technology

Abstract

The transfer of multiple embryos after in vitro fertilization (IVF) increases the risk of twins and higher order births. Multiple births are associated with significant health risks and maternal and neonatal complications, as well as physical, emotional, and financial stresses that can strain families and increase the incidence of depression and anxiety disorders in parents. Elective single-embryo transfer (eSET) is among the most effective methods to reduce the risk of multiple births with IVF. Many patients and clinicians have been reluctant to adopt eSET due to studies reporting higher live-birth rates with the transfer of two or more embryos rather than eSET. The aim of the study was to determine whether elective single blastocyst transfer compromises pregnancy outcomes compared to double blastocyst transfer. The study is prospective observational study which included 25 patients with single blastocyst transfer (group 1) and 27 patients with double blastocyst transfer (group 2) as per the inclusion criteria. Controlled ovarian stimulation (COS) with gonadotropin-releasing hormone antagonist protocol was carried out. The treatment outcomes were compared between the two groups. Data described as mean ± standard deviation or percentages. The statistical analysis was performed using Student t test, the Chi-squared test, and linear regression models. A P-value of <0.05 is considered statistically significant. Statistical analysis was performed with the Statistical Package for Social Sciences (SPSS version 24.0). Statistical analysis showed that the clinical pregnancy rate in the single blastocyst group was 56%, whereas in the double blastocyst group, it was 62.0%. The proportional comparison among the two groups was not found to be statistically significant (P = 0.319), but the multiple pregnancy rate was observed to be 70% in double blastocyst group, whereas in single blastocyst group, it was 0%, which was found to be statistically significant (P = 0.0001). eSET should be encouraged to decrease incidence of multiple pregnancies and associated complications.