Impact of Day 3 or Day 5 Embryo Transfer on Pregnancy Rates and Multiple Gestations
Overview
Affiliations
Objective: To test the hypothesis that day 5 ET (D5ET) is superior to day 3 ET (D3ET) in pregnancy outcome and that it also reduces multiple gestations.
Design: Retrospective cohort study.
Setting: Assisted reproductive technologies program at Wilford Hall Medical Center.
Patient(s): Patients electing for either D3ET or D5ET.
Intervention(s): Participants meeting inclusion criteria for D5ET elected either D3ET or D5ET.
Main Outcome Measure(s): Cycles were compared by day of transfer and further stratified by patient age (<35 years and 35-40 years). The number of oocytes retrieved, embryos on day 3, embryos transferred, pregnancy rate, implantation rate, and twin and high order multiples (>or=triplets) rates were compared.
Result(s): Of the 274 patients who met our inclusion criteria, 153 underwent a D3ET and 121 underwent a D5ET. The D5ET group had a significantly lower mean age and number of embryos transferred and a higher implantation rate (56% vs. 42%) than the D3ET group. Patients who were 35-40 years old had a significantly higher live-birth rate (68% vs. 40%). Although not statistically significant, the D5ET groups had higher clinical pregnancy (73% vs. 65%) and twin pregnancy (33% vs. 25%) rates.
Conclusion(s): Blastocyst transfer resulted in fewer embryos transferred, with a trend toward improved clinical pregnancy and higher twin pregnancy rates. Live-birth rates were improved in patients 35-40 years of age. Younger patients opting for D5ET should do so with a commitment toward single ET.
Ottun T, Adewunmi A, Olumodeji A, Jinadu F J West Afr Coll Surg. 2024; 15(1):37-43.
PMID: 39735804 PMC: 11676021. DOI: 10.4103/jwas.jwas_148_23.
Contesting estimates of cryopreserved embryos in the United States.
Snow D, Cattapan A, Baylis F Nat Biotechnol. 2015; 33(9):909.
PMID: 26348956 DOI: 10.1038/nbt.3342.
Fernandez-Shaw S, Cercas R, Brana C, Villas C, Pons I J Assist Reprod Genet. 2014; 32(2):177-84.
PMID: 25403438 PMC: 4354180. DOI: 10.1007/s10815-014-0387-9.
Patient selection criteria for blastocyst culture in IVF/ICSI treatment.
Thum M, Wells V, Abdalla H J Assist Reprod Genet. 2010; 27(9-10):555-60.
PMID: 20676752 PMC: 2965349. DOI: 10.1007/s10815-010-9457-9.