O-178: Initial experience with elective single embryo transfer applied to an oocyte donation program

Abstract

Couples undergoing oocyte donation have a high risk of having a multiple gestation pregnancy due to the relatively high implantation rates of donated eggs. Many in vitro fertilization (IVF) clinics now offer elective single embryo transfer in an effort to reduce the incidence of multiple gestation and lower the incidence of medical complications of pregnancy. In 2004, our ARTS program offered an incentive program for recipients underoing elective single blastocyst transfer (SBT). The purpose of this study is to review our initial experience on elective SBT in our recipients to determine what effect this program has on the incidence of multiple gestation. A retrospective study was conducted on patients undergoing oocyte donation from 2000 to 2005. The control group consisted of recipients that were treated from January 2000 to December 2003 during which time our ARTS program did not have an organized SBT program. The study group consisted of recipients that were treated from January 2004 to December 2005 during which time our ARTS program offered an incentive for elective SBT. In general, our elective SBT incentive program was offered to couples with two or more good quality blastocyts beginning in 2004. Data for all recipients was collected for number of transfers, number of embryos transferred, pregnancy rates, implantation rates and the proportion of twin/triplets pregnancies. The groups were compared using the Student’s T-test and χ 2 tests when appropriate. Prior to our elective SBT program, multiple gestations were 65% with 62.3% twin sacs and 2.7 % triplet sacs. After our elective SBT program, multiple gestaions were 54.9 % with 51.9% twin sacs and 3.0% triplets sacs. Only 35 (18.8%) recipients elected to have a SBT after our program was initiated, but this compares favorably to the 18 (4.5%) undergoing SBT prior to 2004. More importantly, implantation rates for couples in the study group that elected for a single embryo were 77.1% which indicates that only couples with good quality embyos were offered elective SBT.Tabled 1Tabled 1 Elective SBT should be offered to couples undergoing oocyte donation that have two or more good quality blastocysts. Reasonable pregnancy rates may be achieved in recipients with good quality embryos who elect a SBT without putting these patients at significant risk of multiple gestation. Currently <20% of our recipients elected to have a SBT with a resultant 54.9% multiple gestations indicating a need to further encourage elective SBT.