Single thawed euploid embryo transfer improves IVF pregnancy, miscarriage, and multiple gestation outcomes and has similar implantation rates as egg donation

Hodes-Wertz

et al. 2015

Self Cite

Purpose In Vitro Fertilization is an effective treatment for infertility; however, it has relatively low success in women of advanced maternal age (>37) who have a high risk of producing aneuploid embryos, resulting in implantation failure, a higher rate of miscarriage or birth of a child with chromosome abnormalities. The purpose of this study was to compare the implantation, miscarriage and live birth rates with and without preimplantation genetic screening (PGS) of embryos from patients aged 40 through 43 years. Methods This is a retrospective cohort study, comparing embryos screened for ploidy using trophectoderm biopsy and array comparative genomic hybridization to embryos that were not screened. We compared pregnancy outcomes for traditional fresh IVF cycles with day 5 embryo transfers, Frozen Embryo Transfer (FET) cycles without PGS and PGS-FET (FET of only euploid embryos) cycles of patients with maternal ages ranging from 40 to 43 years, undergoing oocyte retrievals during the period between 1/1/2011 and 12/ 31/2012. Results The implantation rate of euploid embryos transferred in FET cycles (50.9 %) was significantly greater than for unscreened embryos transferred in either fresh (23. Conclusions The present data provides evidence of the benefits of PGS with regard to improved implantation and live birth rate per embryo transferred.

Section: Introductionmentioning

confidence: 99%

In vitro fertilization with preimplantation genetic screening improves implantation and live birth in women age 40 through 43

Lee

Hodes-Wertz

et al. 2015

Self Cite

“…The odds ratios for patients with 3 and 4 available euploid embryos were 1.15 and 1.36 yielding probabilities of clinical pregnancy of 0.54 and 0.58. In order to maintain a live birth rate of roughly 50 % (accounting for roughly 10 % rate of pregnancy loss from euploid transfers [29,30] from a 58 % clinical pregnancy rate) we chose to set the threshold at 4 euploid embryos. Patients were stratified by the number of euploid blastocysts produced (≤3 vs ≥4), as well as the number of embryos transferred (1 vs 2).…”

Section: Resultsmentioning

confidence: 99%

“…Multiple studies have shown that highly graded embryos can be chromosomally abnormal [13,14,15,16] and aneuploidy is the leading cause of failed implantation and miscarriage [17,18,19,20,21,22,23]. While initial attempts at preimplantation genetic screening (PGS) in cleavage stage embryos failed to demonstrate improved pregnancy rates, trophectoderm biopsy coupled with comprehensive chromosomal screening (CCS) [24,25] have yielded encouraging results [26,27,28,29,30].…”

Section: Introductionmentioning

confidence: 99%

A greater number of euploid blastocysts in a given cohort predicts excellent outcomes in single embryo transfer cycles

Morin

Melzer-Ross²,

et al. 2014

Purpose This multicentered retrospective study analyzed whether the quantity of euploid blastocysts in a given cohort after comprehensive chromosomal screening can be used to identify candidates for single embryo transfer. Methods Blastocysts from 437 patients underwent trophectoderm biopsy followed by array comparative genomic hybridization. Embryos were then selected for single or double embryo transfer. The number of euploid blastocysts produced and transferred for each patient was recorded, as was clinical pregnancy rate and multiple gestation rate. Results In patients with e3 euploid blastocysts, clinical pregnancy rate was higher in double, compared to single embryo transfers. However, in patients with Q4 euploid blastocysts, clinical pregnancy rate was not reduced with single embryo transfer was performed, whereas the multiple gestation rate was greatly reduced. Conclusions Size of the euploid embryo cohort is a marker for success in single embryo transfer cycles. Patients who produce at least four euploid blastocysts are outstanding candidates for single embryo transer.

“…Elective single blastocyst embryo transfer has been shown to have equivalent implantation and pregnancy rates compared to double embryo transfer while significantly reducing the rate of twin gestations [16]. Emerging technology like preimplantation genetic screening (PGS) is used to select a single euploid embryo for transfer, therefore, improving pregnancy rates and decreasing the miscarriage rate due to aneuploidy [17][18][19][20]. PGS relies more on blastocyst-stage biopsies which pose less risk of damage to the embryo and allow for the genetic analysis of a greater number of cells reducing the risk of misdiagnosis secondary to mosaicism [21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

A comparison of pregnancy outcomes between day 3 and day 5/6 embryo transfers: does day of embryo transfer really make a difference?

Maxwell

Melzer-Ross²,

et al. 2015

Purpose To determine if day of embryo transfer (ET) affects gestational age (GA) and/or birth weight (BW) at a single university fertility center that primarily performs day 5/6 ET. Methods Retrospective cohort study of 2392 singleton live births resulting from IVF/ICSI at a single large university fertility center from 2003 to 2012. Patients were stratified by day 3 or day 5/6 ET. Outcome variables included patient age, gravidity, prior miscarriages, prior assisted reproduction technology cycles, number of embryos transferred, number of single ET, infertility diagnosis, neonatal sex, GA at birth, and BW. Subanalyses were performed on subgroups of preterm infants. A comparison was made between the study data and the Society of Assisted Reproductive Technologies (SART) published data. Results There was no difference in GA at birth (39±2.1 weeks for day 3 ET, 39±1.9 weeks for day 5/6 ET) or BW between ET groups (3308±568 g for day 3 ET, 3268±543 g for day 5/6 ET). There was also no difference in the number of preterm deliveries (8.5 % for day 3 ET vs. 10.8 % for day 5/6 ET). The day 5/6 ET study data had significantly fewer pre-term deliveries than the SART day 5/6 ET data. Conclusion In contrast to published SART data, GA and BW were not influenced by day of ET. Data may be more uniform at a single institution. Day 5/6 ET continues to offer improved pregnancy rates without compromising birth outcomes.