A novel approach for patients at risk for ovarian hyperstimulation syndrome: elective transfer of a single zona-free blastocyst on day 5

Kinget, Kristof; Nijs, Martine; Cox, Anne-Marie; Janssen, M.; Jacobs, Petra; Bosmans, Eugène; Ombelet, Willem

doi:10.1016/s1472-6483(10)61915-3

Cited by 20 publications

(9 citation statements)

References 25 publications

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“…Related studies have also indicated that recruitment at the blastocyst stage yields better results than selection at day 3, which merely depends on the morphologic evaluation of embryos. These studies also claim that pregnancy rates of up to 50% can be acquired by the transfer of blastocysts when compared with embryo transfer at the cleavage stage ( 15 , 16 , 17 , 18 , 19 , 20 , 21 ) . Similarly, it has been shown that the risk of aneuploidy was significantly lower in day 5 embryos than in day 3 embryos ( 22 ) .…”

Section: Discussionmentioning

confidence: 99%

Day 3 embryo transfer versus day 5 blastocyst transfers: A prospective randomized controlled trial

Hatırnaz¹,

2017

tjod

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Objective:This study aimed to show whether transferring day 5 embryos resulted in higher implantation and pregnancy rates than transferring day 3 embryos in Turkish women undergoing an intracytoplasmic sperm injection (ICSI) cycle.Materials and Methods:A total of 190 women who had ICSI after retrieval of more than four oocytes on the day of fertilization check were randomly assigned to undergo embryo transfer either on day 3 or day 5.Results:Day 3 and day 5 transfers were statistically similar with respect to the age of woman (p=0.107), duration of infertility (p=0.528), cause of infertility (p=0.850), number of collected oocytes (p=0.119), number of metaphase II oocytes (p=0.178), number of fertilized oocytes (p=0.092), and number of transferred embryos (p=0.556). The number of grade 1 embryos was significantly higher in day 5 transfers than in day 3 transfers (p=0.001). Day 3 and day 5 embryo transfers had statistically similar implantation, clinical pregnancy, twinning, and live birth rates (p=0.779, p=0.771, p=0.183, and p=0.649, respectively). The live birth rates in singleton pregnancies conceived after day 3 and day 5 embryo transfers were statistically similar (p=0.594).Conclusion:The efficacy of blastocyst transfer is not inferior to that of embryo transfer on cleavage stage. Performing blastocyst transfer may have benefits because it is associated with acceptable pregnancy rates and morphologic assessment on day 3 has limited predictive value for subsequent embryonic development.

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Section: Discussionmentioning

confidence: 99%

Day 3 embryo transfer versus day 5 blastocyst transfers: A prospective randomized controlled trial

Hatırnaz¹,

2017

tjod

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“…Frozen-thawed embryo transfer appears to not only reduce the risk of multiple gestation but also avoid the ovarian hyperstimulation syndrome [1,2]. Blastocyst culture techniques have improved and the blastocysts can be cyropreserved by vitrification [3].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome of frozen blastocyst transfer; single vs. double transfer

Yanaihara¹,

Yorimitsu²,

Motoyama³

et al. 2008

J Assist Reprod Genet

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Purpose Frozen embryo transfer has been established as an indispensable ART procedure for both the effective use of surplus embryos and the prevention of ovarian hyperstimulation syndrome. The frequency of frozen embryo transfer is increasing in our clinic, and we report that frozen embryo transfer is effective for patients with repeat failures. We present our clinical outcome of frozen blastocyst transfer (FBT). Methods In 2006, 470 patients received FBT (562 cycles (IVF: 354 cycles; ICSI: 208 cycles)). One frozen blastocyst was transferred in 412 cycles (335 patients) and two blastocysts were transferred in 150 cycles (135 patients). Assisted hatching was performed in all cases. Results In 412 cycles (average age: 34.6 years) who received a single FBT, the rate of clinical pregnancy per cycle was 40.7%, the live birth rate was 29.1%, the abortion rate was 21.6%, the ectopic pregnancy rate was 1.2%, the frequency of monochorionic twins was 2.3%, and the cesarean section rate was 38.3%. In 150 cycles (average patient age 34.8 years) who received two FBTs, the clinical pregnancy rate was 46%, the live birth rate was 35.3%, the abortion rate was 16.3%, the ectopic pregnancy rate was 4.4%, the frequency of twins was 15.9% and the cesarean section rate was 39.6%. A significant difference in the ectopic pregnancy rate and the twinning rate was found between single transfers and double transfers (P<0.05). When IVF and ICSI were compared, there was no statistically significant difference in the abortion rate, the ectopic pregnancy rate, and the cesarean section rate. Conclusions The clinical pregnancy rate was similar for the transfer of one and two blastocysts. Single FBT decreases obstetrical risk without reducing the pregnancy rate.

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“…Severe ascites, hypovolemia, or electrolyte imbalance did not occur, and no patients were hospitalized. employ single blastocyst transfer in patients at risk of developing severe OHSS (108,109). Such a strategy results in a negligible multiple gestation rate, which purportedly is associated with more severe OHSS presumably secondary to higher hCG levels.…”

Section: Gnrh-antagonists and Ohssmentioning

confidence: 99%