Comparison of pregnancy rates in favorable prognosis women receiving an elective single or double embryo transfer

Abstract

OBJECTIVE: To determine if there is a difference in pregnancy rates between women receiving an elective single embryo transfer (eSET) and those receiving a double embryo transfer (DET) in women with a favorable prognosis. Also, to determine if multiple gestation rates were lower with the transfer of a single embryo.DESIGN: The study was a retrospective cohort study conducted in a private practice setting.MATERIALS AND METHODS: We performed a retrospective chart review of favorable prognosis patients in our database from January 2006 through January 2009 of all patients undergoing fresh, non-donor in-vitro fertilization (IVF). To be included women had to be less than 37 years old, undergoing their first IVF cycle. They needed to have: 2 or more blastocysts with grade of 3BB or better using the Gardner blastocyst grading system, cycle day 3 FSH level less than 10.2pg/ml, and a minimum of 30% of fertilized eggs progressing to the blastocyst stage. All subjects were recommended by the physicians to receive a single embryo, but then were given the choice of transferring either a single or double embryo.Table 1Pregnancy outcomes.Clinical pregnancyOne blastocystTwo blastocystsTotalPositive523284Negative17623Total6938107Pearson chi (2)=1.1369, Pr=0.286.There were 3 (6%) twins in the ESET group, while there were 10 twins and 2 triplets (38%) in the DET group, p=0.001. Open table in a new tab CONCLUSIONS: Among women with a favorable prognosis, clinical pregnancy rates are similar in those who undergo single as opposed to double embryo transfers. Double embryo transfers result in a higher risk of multiple gestations, which increases both maternal and fetal morbidity and mortality. OBJECTIVE: To determine if there is a difference in pregnancy rates between women receiving an elective single embryo transfer (eSET) and those receiving a double embryo transfer (DET) in women with a favorable prognosis. Also, to determine if multiple gestation rates were lower with the transfer of a single embryo. DESIGN: The study was a retrospective cohort study conducted in a private practice setting. MATERIALS AND METHODS: We performed a retrospective chart review of favorable prognosis patients in our database from January 2006 through January 2009 of all patients undergoing fresh, non-donor in-vitro fertilization (IVF). To be included women had to be less than 37 years old, undergoing their first IVF cycle. They needed to have: 2 or more blastocysts with grade of 3BB or better using the Gardner blastocyst grading system, cycle day 3 FSH level less than 10.2pg/ml, and a minimum of 30% of fertilized eggs progressing to the blastocyst stage. All subjects were recommended by the physicians to receive a single embryo, but then were given the choice of transferring either a single or double embryo. Pearson chi (2)=1.1369, Pr=0.286. There were 3 (6%) twins in the ESET group, while there were 10 twins and 2 triplets (38%) in the DET group, p=0.001. CONCLUSIONS: Among women with a favorable prognosis, clinical pregnancy rates are similar in those who undergo single as opposed to double embryo transfers. Double embryo transfers result in a higher risk of multiple gestations, which increases both maternal and fetal morbidity and mortality.