Abstract
ObjectiveART has helped millions of infertile couples worldwide to overcome their childlessness. These successes have been accompanied by an increase in multiple deliveries, and perinatal complications associated. The explanation for this complication is the transfer of more than one embryo, to increase the odds of delivery. Our objective was to compare the outcome of elective dual embryo transfer (eDET) to that of the transfer of more than two embryos without embryo cryopreservation (TET), terms of delivery rate and multiple delivery.MethodsWe analyzed the data registered by 155 clinics members of the RLA: 11,024 eDET and 10,634 TET.ResultsThe delivery rate was significantly higher when eDET was performed than when TET was performed (40.24% and 26.98%, p < 0.001). Also, the ratio of twin deliveries was higher in eDET (25.80% and 20.56%, p < 0.001). However, the ratio of triplets and more deliveries was higher in TET than in eDET (2.34%and 0.52%, p < 0.001). These findings were consistent across the different age categories of the female partner.ConclusionOur findings suggest that eDET was associated with a statistically significant better delivery rate per embryo transfer, and lower ratio of triplet-and-higher deliveries, regardless of the woman’s age. Therefore, there is no evidence that supports the transfer of more than two embryos.
Highlights
Between 1990 and 2013, 144,287 babies have been born in Latin America due to assisted reproductive techniques
Our findings suggest that elective dual embryo transfer (eDET) was associated with a statistically significant better delivery rate per embryo transfer, and lower ratio of triplet-and-higher deliveries, regardless of the woman’s age
It is widely recognized that elective single embryo transfer is the only way to avoid multiple pregnancies and multiple births, only 1.4% of embryo transfers performed in the region corresponded to eSET, while 21% corresponded to the elective transfer of two embryos (Zegers-Hochschild et al, 2016)
Summary
Between 1990 and 2013, 144,287 babies have been born in Latin America due to assisted reproductive techniques. These success stories have been associated with an increase in multiple births because of the transfer of more than one embryo. Multiple pregnancies and deliveries have been associated with an increase in the risk for the mother (gestational hypertension, preeclampsia, gestational diabetes) and for the neonate (preterm delivery, low birth weight (Qin et al, 2015; Geisler et al, 2014). It is widely recognized that elective single embryo transfer (eSET) is the only way to avoid multiple pregnancies and multiple births, only 1.4% of embryo transfers performed in the region corresponded to eSET, while 21% corresponded to the elective transfer of two embryos (eDET) (Zegers-Hochschild et al, 2016)
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