Effect of patient's age on the criteria for day 5 embryo transfers

Abstract

OBJECTIVE: Criteria are used to determine when patients should have a Day 3 (D3) or Day 5 (D5) embryo transfer (ET) with most dependent on the no. of embryos available on D3. Patients who meet the criteria have a D5 ET allowing for the transfer of potentially better quality embryos. Our program's criteria for a D5 transfer has been ≥ 4 good quality embryos at ≥7-cell stage on D3, and has been used regardless of the age of the patient. The objective of this study was to determine the effect of patient age on D5 ET results.DESIGN: Retrospective data analysis.MATERIALS AND METHODS: Data was analyzed on IVF patients < 41 years of age with ≥ 4 embryos on D3 who received an ET from 2006 and 2007. Patients were divided into two age groups: ≤ 34 years and patients 35 to 40 years. Patients were again divided into 1) those that did not meet the criteria for extended culture and had a D3 ET and 2) those that met the criteria and underwent a D5 ET. The variables analyzed included no. of embryos, no. embryos transferred, implantation (imp.) and clinical pregnancy rate (PR).Tabled 1Day 3 TransfersDay 5 TransfersPMean No. 2PN6.59.50.0001Mean No. Embryos Transferred3.12.10.0001Implantation (%)66/300 (22)33/112 (29)NSClinical Pregnancy (%)47/96 (48)21/52 (40)NS Open table in a new tab CONCLUSIONS: Our study found patients ≥ 35 years may not benefit from a D5 transfer using our current criteria. This may be due to the lower number of embryos transferred on D5. Rather than increasing the number of embryos that are transferred on D5 and risk increasing the rate of multiple pregnancies, our program has amended our D5 ET protocol for patients ≥ 35 to be ≥ 6 good quality embryos on the morning of D3. To date, this change has resulted in an increased rate of both imp.and PR by allowing us to select better quality embryos for transfer on both Days 3 and 5. OBJECTIVE: Criteria are used to determine when patients should have a Day 3 (D3) or Day 5 (D5) embryo transfer (ET) with most dependent on the no. of embryos available on D3. Patients who meet the criteria have a D5 ET allowing for the transfer of potentially better quality embryos. Our program's criteria for a D5 transfer has been ≥ 4 good quality embryos at ≥7-cell stage on D3, and has been used regardless of the age of the patient. The objective of this study was to determine the effect of patient age on D5 ET results. DESIGN: Retrospective data analysis. MATERIALS AND METHODS: Data was analyzed on IVF patients < 41 years of age with ≥ 4 embryos on D3 who received an ET from 2006 and 2007. Patients were divided into two age groups: ≤ 34 years and patients 35 to 40 years. Patients were again divided into 1) those that did not meet the criteria for extended culture and had a D3 ET and 2) those that met the criteria and underwent a D5 ET. The variables analyzed included no. of embryos, no. embryos transferred, implantation (imp.) and clinical pregnancy rate (PR). CONCLUSIONS: Our study found patients ≥ 35 years may not benefit from a D5 transfer using our current criteria. This may be due to the lower number of embryos transferred on D5. Rather than increasing the number of embryos that are transferred on D5 and risk increasing the rate of multiple pregnancies, our program has amended our D5 ET protocol for patients ≥ 35 to be ≥ 6 good quality embryos on the morning of D3. To date, this change has resulted in an increased rate of both imp.and PR by allowing us to select better quality embryos for transfer on both Days 3 and 5.