Selectively targeted blastocyst embryo transfer: optimizing ivf pregnancy results while minimizing risks and side effects

Abstract

Research Question: Is single embryo transfer a reasonable option. Design: Material and methods: This is a retrospective cohort study conducted in a single IVF center. These patients consisted of 96 patients using egg donors and 92 patients using their own eggs for a total of 188 patients undergoing IVF-ICSI. Results: Among 96 patients who received donor eggs, 59 women (61%) were positive for pregnancy tests, resulting in 40 live births (68% per Pregnancy). On the other hand, of 92 patients who received their own egg, 34 patients (37%) were positive in terms of pregnancy tests, resulting in 15 live births (44% per pregnancy). Overall, of all 55 live births, 24 were multiple pregnancies. Interestingly, all multiple pregnancies occured in patients <35 years of age. All of these multiples resulted from the transfer of two blastocysts of grade A. Conclusion: These results corroborate and enhance the various reproductive society recommendations that a selective single embryo transfer at the blastocyst stage and above would be a feasible option in patients less than 38 years of age, especially in patients using egg donors younger than 33 years of age, while resulting in a reasonably high successful singleton live birth rate. This is based on the predicted calculation of a 42.5% singleton live birth per egg donor pregnancy, and a 28% singleton live birth per pregnancy for patients using their own eggs. Summary: Patients who had Blastocyst or above grade A had a 63.7% biochemical or clinical positive pregnancy test result and a 40.7% Live birth. Whilst, patients with blastocysts of other grades or lower stages of development, resulted in 30.7% positive biochemical or clinical pregnancy with 10.7% live birth.