Prospective evaluation of the optimal time for selecting a single embryo for transfer: day 3 versus day 5

Purpose To compare the clinical outcomes of elective single morula embryo transfer (eSMET) versus elective single blastocyst embryo transfer (eSBET) in selected patients. Methods This study was a retrospective study which analyzed for 271 cycles in women under 37 years of age who are undergoing their first or second trial of in vitro fertilization-embryo transfer (IVF-ET) from January 2008 to December 2009. The eSMET was performed on day 4 (n0130) and the eSBET was conducted on day 5 (n0141). Results The clinical pregnancy rate (51.5% vs. 51.8%, p0 0.97), implantation rate (52.3% vs. 52.5%, p00.98), and live birth rate (39.2% vs. 44.7%, p00.36) were similar in the eSMET and eSBET groups, respectively. The miscarriage rate of the eSMET group (23.9%) was slightly higher than that of the eSBET group (13.7%) (p00.12), without reaching statistical significance. There was only one case of monozygotic twin pregnancy in each group. ConclusionsThe clinical outcomes of day 4 eSMET were comparable to those of day 5 eSBET. Therefore, day 4 eSMET is a viable option or an alternative to day 5 eSBET, with no difference in success rates.

Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 95%

Clinical outcomes of elective single morula embryo transfer versus elective single blastocyst embryo transfer in IVF-ET

Kang

Lee

Jeong

et al. 2012

“…The selection of embryos on day 5 proved to be a much better technique for selecting the fittest embryos that are most likely to implant [16][17][18]. Angelini et al showed that a higher experienced physician had significant higher CPR and implantation rate.…”

Section: Discussionmentioning

confidence: 99%

Effects of embryo transfer quality on pregnancy and live birth delivery rates

Spitzer

Haidbauer

Corn

et al. 2011

Background To analyze the effects of embryo transfer (ET) quality on clinical pregnancy (CPR) and live birth delivery rates (LBDR). Methods In a retrospective study at a single, private infertility center between November 2005 and December 2009 one thousand fifty-five day-3 and day-5 ETs following IVF/ICSI/IMSI were evaluated. We analyzed the impact of an atraumatic ET with a soft catheter (ET 1), after external guidance (ET 2), after probing of the cervix with a stylet (ET 3), or after grasping the portio vaginalis with a tenaculum (ET 4) on CPR and LBDR. Results The use of external guidance showed a significantly reduced LBDR as compared to an atraumatic ET (26.0% vs. 32.5%). The lowest CPR and LBDR were found in ET 4. The application of stylets in cases of difficult ETs was superior to the use of external guidance. No differences in miscarriages between ET 1-4 were noted. Conclusions Besides embryo culture and patient history, the quality of an ET might also have an important impact on pregnancy outcome. Techniques to ensure an atraumatic ET, such as mechanic uterine cavity length measurements, before starting treatment might help identify patients at risk for a difficult ET and lead to modified treatments, such as the primary use of a stylet. Limitation of study: retrospective analysis

“…Conventional controlled ovarian stimulation (cCOS) was performed using the gonadotrophin-releasing hormone (GnRH) long protocol [5]. Final oocyte maturation and the induction of ovulation were performed with 10,000 IU hCG (Ferring Arzneimittel, Vienna, Austria).…”

Section: Ovarian Stimulation and Oocyte Retrievalmentioning

confidence: 99%

“…The observations of higher implantation, pregnancy, and birth rates in day 5 transfers might be a combination of all these factors. Even though it has been shown that the prolonged culture and subsequent selection for single embryo transfer (SET) is still the most promising approach to increase pregnancy and life birth rates in IVF cycles [4,5], the application of blastocyst transfers in the practice of assisted reproduction techniques (ART) is still highly controversial. There are multiple reasons for this.…”

Section: Introductionmentioning

confidence: 99%

The impact of paternal factors on cleavage stage and blastocyst development analyzed by time-lapse imaging—a retrospective observational study

Neyer

Zintz

Stecher

et al. 2015

Self Cite

Purpose Various time-lapse studies have postulated embryo selection criteria based on early morphokinetic markers. However, late paternal effects are mostly not visible before embryonic genome activation. The primary objective of this retrospective study was to investigate whether those early morphokinetic algorithms investigated by time-lapse imaging are reliable enough to allow for the accurate selection of those embryos that develop into blastocysts, while of course taking into account the correlation with the type of injected spermatozoa. Methods During a period of 18 months, a total of 461 MII oocytes from 43 couples with severe male factor infertility and previous Bexternal^IVF failures after cleavage-stage embryo transfer (ET) were fertilized by intracytoplasmic morphologically selected sperm injection (IMSI). Thereof, 373 embryos were monitored in a time-lapse incubator until ET on day 5. Blastocyst outcome in combination with three previously postulated MKc (cc2: t3-t2, 5-12 h; t3, 35-40 h; t5, 48-56 h) and the morphology of the selected sperm were analyzed. Results A significant increase in the rate of blastocysts (54.0 vs. 36.3 %; P<0.01) and top blastocysts (25.3 vs. 10.8 %; P<0.001) was observed in the group of those meeting all three morphokinetic criteria (MKc3). However, MKc3 were only met in 23.3 % of all embryos. Moreover, TBR was influenced by the type of injected spermatozoa. In both groups, TBR decreased dramatically (MKc3, 35.0 vs. 17.0 %; MKc<3, 14.2 vs. 8.4 %) when class II/III sperm instead of class I were injected. Conclusion Early morphokinetic parameters might give some predictive information but fail to serve as a feasible selective tool for the prediction of blastocyst development given the influence of the type of spermatozoa injected.