Elective Single Blastocyst Transfer in Advanced Maternal Age

Overview

Journal J Assist Reprod Genet

Publisher Springer

Specialties Genetics
Reproductive Medicine

Date 2017 Mar 17

PMID 28299549

Citations 17

Authors

Samer Tannus

Weon-Young Son

Michael Haim Dahan

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to investigate reproductive outcomes following elective single blastocyst transfer (eSBT) compared with those of double blastocyst transfer (DBT) in advanced maternal age.

Methods: This was a retrospective cohort study performed at an academic fertility center. All women aged 40 and over for whom in vitro fertilization (IVF) cycles were performed and in whom embryo culture was extended to the blastocyst stage were reviewed for possible inclusion. Exclusion criteria included the following: women with >3 previous IVF cycles, the use of donor or frozen oocytes, preimplantation genetic diagnosis/preimplantation genetic screening cycles, and cycles in which embryos did not reach the blastocyst stage on day 5. The study included 310 women; 148 were included in the eSBT group and 162 were included in the DBT group. Live birth rate (LBR) was the main outcome. Outcomes were analyzed using logistic regression, controlling for confounders. These confounders were embryo expansion, embryo quality, and the number of previous IVF cycles.

Results: The mean age of the whole group was 41 ± 0.91 years, and the LBR was 21.6%. The eSBT group and the DBT group achieved similar clinical pregnancy rates (33 vs. 33%) (OR 1.04; 95%CI, 0.62-1.75) and LBRs (20 vs. 22.8%) (OR 1.43; 95% CI, 0.78-2.64). The multiple birth rate was lower in the eSBT group (0 vs. 16%, p = 0.02). The subgroup of women who had elective DBT (eDBT) achieved a higher LBR (20 vs. 30.6%) (OR 2.32; 95% CI, 1.16-4.68) and a higher multiple birth rate (0 vs. 22%, p = 0.001). Cycles with early blastocyst transfers were associated with lower LBRs compared with cycles with fully expanded blastocyst transfers (11 vs. 24%, p = 0.02).

Conclusion: The results of this study indicate that eSBT is associated with similar LBRs compared to the entire DBT cohort; however, when supernumerary blastocysts are available for cryopreservation, eDBT is associated with both higher LBRs and a higher number of multiple births. Studies assessing the cumulative LBR in advanced maternal age after single blastocyst transfer and subsequent frozen-thawed blastocyst transfers are needed.

Citing Articles

What is the optimal number of embryos to transfer for POSEIDON group 1 and group 2? A retrospective study.

Liu R, Zhang Q, Geng L, He H, Xu C, Feng J J Ovarian Res. 2024; 17(1):117.

PMID: 38822354 PMC: 11140960. DOI: 10.1186/s13048-024-01443-y.

The effect of intrauterine insemination preceding frozen-thawed elective single embryo transfer in couples with unexplained subfertility.

Oner G, Ciftci B, Turktekin N, Tas M, Ulug P, Kumtepe Y Arch Med Sci. 2024; 20(1):81-85.

PMID: 38414457 PMC: 10895936. DOI: 10.5114/aoms.2020.98412.

Single versus double blastocyst transfer in first and second frozen-thawed embryo transfer cycle in advance-aged women: a two-center retrospective cohort study.

Zhou Y, Ji H, Zhang M, Zhang J, Li X, Zhang J BMC Womens Health. 2024; 24(1):51.

PMID: 38238733 PMC: 10795208. DOI: 10.1186/s12905-023-02753-x.

Comparison of frozen-thaw blastocyst transfer strategies in women aged 35-40 years: a retrospective study.

Wu Y, Lu X, Chen H, Fu Y, Zhao J Front Endocrinol (Lausanne). 2023; 14:1141605.

PMID: 37404307 PMC: 10315647. DOI: 10.3389/fendo.2023.1141605.

Single-embryo transfer: a key strategy to reduce the risk for multiple pregnancy in assisted human reproduction.

Reimundo P, Gutierrez Romero J, Perez T, Veiga E Adv Lab Med. 2023; 2(2):179-198.

PMID: 37363329 PMC: 10197809. DOI: 10.1515/almed-2021-0013.

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