Dataset Information

[Pregnancy and obstetric outcomes of elective single versus double cleavage-stage embryo transfer].

ABSTRACT: OBJECTIVE:To compare the pregnancy and obstetric outcomes in elective single versus two cleavage-stage embryo transfer. METHODS:Fresh cleavage-stage embryo transfer cycles between January, 2014 and October, 2015 were reviewed, including 39 single embryo transfer (eSET) cycles and 200 double embryo transfer (DET) cycles. The clinical pregnancy rates, implantation rates, multiple pregnancy rates, live birth rate, and obstetric outcomes (gestational age, preterm delivery rate and mean birth weight) were compared between the two groups. RESULTS:The baseline characteristics were comparable between the two groups. The estradiol level on the day of trigger and the oocyte number were significantly higher in eSET group than in DET group (10654.4 pmol/L vs 8284.2 pmol/L and 8.4 vs 7.0, respectively). No significant difference was found in the pregnancy rate (56.4% vs 66.0%) or live birth rate (48.7% vs 51.5%) between the two groups, and their implantation rates differed significantly (56.4% vs 37.8%). No multiple pregnancies occurred in eSET group while the rate of multiple pregnancies was 22.7% in DET group. The gestational age and mean birth weight were significantly higher in eSET group (P<0.05), and the preterm delivery rate after DET was nearly three times of that after eSET, although this difference was not statistically significant. CONCLUSIONS:Elective single embryo transfer can be performed without compromising the live birth rates. Multiple pregnancy rates can be significantly reduced with eSET, which also results in a higher chance of delivering a term singleton live birth compared with DET.

SUBMITTER: Sun L

PROVIDER: S-EPMC6744098 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

[Pregnancy and obstetric outcomes of elective single versus double cleavage-stage embryo transfer].

Sun Ling L Chen Zhi-Heng ZH Yin Min-Na MN Deng Yu Y Liu Jun J

Nan fang yi ke da xue xue bao = Journal of Southern Medical University 20160401 4

<h4>Objective</h4>To compare the pregnancy and obstetric outcomes in elective single versus two cleavage-stage embryo transfer.<h4>Methods</h4>Fresh cleavage-stage embryo transfer cycles between January, 2014 and October, 2015 were reviewed, including 39 single embryo transfer (eSET) cycles and 200 double embryo transfer (DET) cycles. The clinical pregnancy rates, implantation rates, multiple pregnancy rates, live birth rate, and obstetric outcomes (gestational age, preterm delivery rate and mea ...[more]

PMID: 28446405

Similar Datasets

Project description:Embryo quality is associated with successful implantation and live births. Our retrospective study was carried out to determine whether or not cleavage stage embryo quality affects the miscarriage rate, pregnancy complications and neonatal outcomes of singletons conceived with assisted reproduction technology.The current study included 11,721 In Vitro Fertilization-Embryo Transfer cycles (IVF-ET) between January 2009 (the date at which electronic medical records were implemented at our center) and March 2013. Only women?<?40 years of age undergoing their first fresh embryo transfer cycle using non-donor oocytes were included.Our study indicated that the transfer of poor-quality embryos resulted in higher miscarriage (19.77% vs. 13.28%, p?=?0.02) and lower ongoing pregnancy rates (15.33% vs. 48.06%, p?<?0.001). Logistic regression analysis performed on data derived from 744 cycles culminating in miscarriages versus 4,333 cycles culminating in live births, suggested that embryo quality (p?=?0.04) is significantly associated with miscarriage rate after adjusting for other confounding factors. Moreover, there were no differences in the mean birth weight, low birth weight (<2,500 g), very low birth weight (<1,500 g), gestational age, preterm delivery (<37 weeks), very preterm delivery (<32 weeks), congenital malformations, small-for-gestational-age singletons (SGA), and large-for-gestational-age singleton (LGA) rate (p?>?0.05). Similarly, pregnancy complications resulting from poor-quality embryos were not different from good-quality embryos (4.04% vs. 2.57 %, p?=?0.33). Finally, logistic regression suggested that embryo quality was not significantly associated with pregnancy complications after adjusting for other confounding factors (p?=?0.40).Our study suggests that transfer of poor-quality embryos did not increase the risk of adverse outcomes; however, the quality of cleavage stage embryos significantly affected the miscarriage rate and ongoing pregnancies.

Project description:ObjectiveTo compare the effectiveness of elective single embryo transfer versus double embryo transfer on the outcomes of live birth, multiple live birth, miscarriage, preterm birth, term singleton birth, and low birth weight after fresh embryo transfer, and on the outcomes of cumulative live birth and multiple live birth after fresh and frozen embryo transfers.DesignOne stage meta-analysis of individual patient data.Data sourcesA systematic review of English and non-English articles from Medline, Embase, and the Cochrane Central Register of Controlled Trials (up to 2008). Additional studies were identified by contact with clinical experts and searches of bibliographies of all relevant primary articles. Search terms included embryo transfer, randomised controlled trial, controlled clinical trial, single embryo transfer, and double embryo transfer. Review methods Comparisons of the clinical effectiveness of cleavage stage (day 2 or 3) elective single versus double embryo transfer after fresh or frozen in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatments were included. Trials were included if the intervention differed only in terms of the intended number of embryos to be transferred. Trials that involved only blastocyst (day five) transfers were excluded.ResultsIndividual patient data were received for every patient recruited to all eight eligible trials (n=1367). A total of 683 and 684 women randomised to the single and double embryo transfer arms, respectively, were included in the analysis. Baseline characteristics in the two groups were comparable. The overall live birth rate in a fresh IVF cycle was lower after single (181/683, 27%) than double embryo transfer (285/683, 42%) (adjusted odds ratio 0.50, 95% confidence interval 0.39 to 0.63), as was the multiple birth rate (3/181 (2%) v 84/285 (29%)) (0.04, 0.01 to 0.12). An additional frozen single embryo transfer, however, resulted in a cumulative live birth rate not significantly lower than the rate after one fresh double embryo transfer (132/350 (38%) v 149/353 (42%) (0.85, 0.62 to 1.15), with a minimal cumulative risk of multiple birth (1/132 (1%) v 47/149 (32%)). The odds of a term singleton birth (that is, over 37 weeks) after elective single embryo transfer was almost five times higher than the odds after double embryo transfer (4.93, 2.98 to 8.18).ConclusionsElective single embryo transfer results in a higher chance of delivering a term singleton live birth compared with double embryo transfer. Although this strategy yields a lower pregnancy rate than a double embryo transfer in a fresh IVF cycle, this difference is almost completely overcome by an additional frozen single embryo transfer cycle. The multiple pregnancy rate after elective single embryo transfer is comparable with that observed in spontaneous pregnancies.

Project description:BACKGROUND:With improvements in in vitro culture techniques there has been a steady shift in practice to transfer embryos at the blastocyst stage (post fertilization day (p.f.d.) 5-7), when embryos reach the endometrial cavity during natural conception. For patients with >?5 zygotes on day 1 of embryo development, fresh blastocyst embryo transfer (ET) increases live birth rates when compared to cleavage stage (p.f.d. 3) transfer. In poorer prognosis patients (? 5 zygotes) cleavage stage ET is commonly performed to reduce the risk of cycle cancellation if no embryo survives to the blastocyst stage. However, there is a dearth of randomized controlled trial (RCT) data demonstrating improved live birth rates per cycle for cleavage vs blastocyst stage ET in this subgroup of patients. The hypothesis of the PRECiSE (PooR Embryo Yield Cleavage Stage Versus blaStocyst Embryo Transfer) trial is that blastocyst ET is not inferior to cleavage stage ET with regard to live birth rates per retrieval in poorer prognosis patients. The adoption of routine blastocyst culture for all patients would result in higher rates of single embryo transfers (SET), reduced incidence of multiple pregnancies and simplified laboratory protocols, thereby reducing costs. METHODS/DESIGN:Multicenter, non-inferiority randomized controlled trial (RCT) comparing blastocyst to cleavage stage embryo transfer in poorer prognosis patients with ?5 zygotes on day 1 after fertilization. The primary outcome is live birth per retrieval. Secondary outcomes include: time to pregnancy, clinical pregnancy, ongoing pregnancy, miscarriage and multiple pregnancy rate (per retrieval). This trial will enroll 658 women with ?5 zygotes on day 1 at 6 IVF centers over the course of 22?months. DISCUSSION:If the hypothesis is proven true, the data from this trial may facilitate the adoption of uniform blastocyst culture in all IVF patients. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT03764865. Registered 5 December 2019, Protocol issue date: 4 December 2018, Original.

Project description:PURPOSE:Is there a difference in implantation and pregnancy rates between embryos transferred electively at cleavage or blastocyst stage in infertile women ??38 years with at least four zygotes on day 1 post retrieval? METHODS:A randomized clinical trial was conducted in a single tertiary care hospital with a sample size of 194 patients in each arm for a total population of 388 women. Patients less than 39 years of age with more than three fertilized oocytes and less than four previous assisted reproductive technology (ART) attempts were inclusion criteria. RESULTS:The two groups were similar for age, years of infertility, indication to treatment, basal antimüllerian hormone and FSH, number of previous ART cycles, primary or secondary infertility, type of induction protocol, days of stimulation, total gonadotrophin dose, and estradiol (E2) and progesterone (P) levels at trigger. No statistically significant differences were found in terms of number of retrieved oocytes, inseminated oocytes, fertilization rate, canceled transfers (7.73% in blastocyst and 3.61% in cleavage stage group), and cycles with frozen embryos and/or oocytes. Although a higher number of fertilized oocytes were in the blastocyst stage group (6.18?±?1.46 vs 5.89?±?1.54, p?=?0.052), a statistically greater number of embryos/randomized cycle were transferred at cleavage stage (1.93?±?0.371) compared with the number of transferred blastocysts (1.80?±?0.56), probably due to the number of embryos not reaching blastocyst stage (3.09%). The implantation rate (28.37 vs 25.67%), pregnancy rate per cycle (36.06 vs38.66%), transfer (39.66 vs 40.11%), spontaneous abortions (19.72% vs 12.00%), delivery rate per cycle (27.84 vs 32.99%), and transfer (30.17 vs 34.22%) were not significantly different between the blastocyst and cleavage stage groups. The twin delivery rate was higher in the blastocyst stage group, although not significant (42.59 vs 28.12%). The mean numbers of frozen blastocyst (2.30?±?1.40 vs 2.02?±?1.00) and frozen oocytes (7.09?±?3.55vs 6.79?±?3.26) were not significantly different between the two groups. CONCLUSIONS:Fresh blastocyst-stage transfer versus cleavage-stage transfer did not show any significant difference in terms of implantation and pregnancy rate in this selected group of patients. A high twin delivery rate in both groups (35.59%) was registered, and although not significant, they were higher in the blastocyst transfer group (42.59 vs 28.12%). Our conclusion supports considering single embryo transfer (SET) policy, even in cleavage stage in patients younger than 39 years with at least four zygotes. TRIAL REGISTRATION:ClinicalTrials.gov registration number NCT02639000.

Dataset Information

[Pregnancy and obstetric outcomes of elective single versus double cleavage-stage embryo transfer].

Publications

[Pregnancy and obstetric outcomes of elective single versus double cleavage-stage embryo transfer].

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets