Success of Fertility, Embryo Number, and in-Vitro Fertilisation

Craft, Ian; Porter, Robert H.; Green, Steve; Tucker, Michael; Smith, Bill; Twigg, Hilary; Ahuja, Kamal; Whittingham, D. G.

doi:10.1016/s0140-6736(84)92241-4

Cited by 16 publications

(8 citation statements)

References 5 publications

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“…The reference lists of included articles were also reviewed to identify additional relevant studies. Studies were included if they met the following criteria: the study population included women of reproductive age undergoing IVF or intracytoplasmic sperm injection (ICSI) in nondonor cycles; [ 2 ] the number of embryos transfers was recorded for all participants; [ 3 ] the clinical outcome of implantation and/or clinical pregnancy was recorded; and [ 4 ] any study design except case reports.…”

Section: Methodsmentioning

confidence: 99%

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Elective single embryo transfer- the power of one

Lee

Connell

Csokmay

et al. 2016

Contracept Reprod Med

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Despite the highest historical live birth success rates for couples undergoing in vitro fertilization (IVF), there has been an epidemic of iatrogenic twin and higher order gestation conceived from this treatment. Continued improvement in cryopreservation techniques have allowed preservation of supernumerary embryos for use in future cycles, and refinements in culture systems and embryo selection have resulted in the transfer of fewer embryos while maintaining favorable pregnancy rates. The voluntary transfer of a single high quality embryo, elective single embryo transfer (eSET), has significantly reduced multiple gestation rates and maximized the rate of singleton pregnancy without compromising overall success rates. Although eSET is the standard of care in several developed countries, utilization in the United States has been slow. States with mandated IVF insurance have seen decreases in preterm birth rates yielding down stream health care savings. Herein, the evolution and future applications of this practice to reduce the risk of iatrogenic twins is reviewed.

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Section: Methodsmentioning

confidence: 99%

“…Multiple embryos were transferred to maximize pregnancy rates. As a result, the debate surrounding the ideal number of embryos for transfer was born and has been ongoing for the past three decades [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Elective single embryo transfer- the power of one

Lee

Connell

Csokmay

et al. 2016

Contracept Reprod Med

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“…However, the implantation rate of these embryos after embryo transfer is disappointing. Although up to 30% of patients receiving more than one embryo become pregnant (Edwards & Steptoe, 1983), the rate of pregnancies per oocyte is only about 10% (Speirs et al, 1982, Lopata, 1983Kerin et al, 1983;Craft et al, 1984). Amongst the many factors that could contribute to this low rate of success, suboptimal conditions during culture might be important.…”

Section: Introductionmentioning

confidence: 99%

Metabolism of glucose by human embryos

Wales¹,

Whittingham²,

Hardy³

et al. 1987

Reproduction

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Glucose turnover, as measured by CO2 production, lactate accumulation and carbon incorporation from [U-14C]glucose as sole energy substrate, was low on the 2nd day of culture of human embryos resulting from in-vitro fertilization but above that of unfertilized oocytes. In general, all parameters of metabolism increased substantially during the following 2 days of development but the rate of increase in lactate production was greater than that of CO2, especially between Days 3 and 4. Within developing embryos, no correlation was evident between the metabolic turnover of glucose and the method of patient stimulation, the morphological quality of embryos or the apparent rate of cleavage in culture. The results indicate that, before Day 3 of development, glucose is not effective as an energy source for the human embryo because of a blockade to glycolysis similar to that in mouse embryos.

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“…The pronounced increase in multiple pregnancies was directly attributable to frequently replacing more than one embryo after fertilisation.9 10 One monozygotic twin pregnancy, however, was recorded after replacement of a single embryo. The ratio of twins of like to unlike sex was 2:1, whereas equal numbers would be expected if all were dizygotic twins resulting from fertilisation of more than one oocyte.…”

Section: Discussionmentioning

confidence: 99%

High incidence of preterm births and early losses in pregnancy after in vitro fertilisation. Australian in vitro fertilisation collaborative group.

1985

BMJ

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A fertilisation cohort of 244 pregnancies resulting from in vitro fertilisation was reported to a national register by eight units specialising in in vitro fertilisation. Early pregnancy losses were high, with 5% tubal ectopic pregnancies, 18% biochemical pregnancies, and an incidence of spontaneous abortion of 27%. Among pregnancies of at least 20 weeks' gestation 22% were multiple, with 26 pairs of twins and four sets of triplets. The incidence of preterm births was more than three times higher than in the general population. Low birthweight rates were also higher, owing both to preterm births and to multiple pregnancies. The sex ratio and the incidence of major congenital malformations were similar to those in naturally conceived pregnancies.In this series the high fetal losses at all stages of pregnancy suggested maternal reproductive causes and should not be interpreted as being due to factors peculiar to in vitro fertilisation. Further analysis will be necessary when larger numbers are available.

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Success of Fertility, Embryo Number, and in-Vitro Fertilisation

Cited by 16 publications

References 5 publications

Elective single embryo transfer- the power of one

Elective single embryo transfer- the power of one

Metabolism of glucose by human embryos

High incidence of preterm births and early losses in pregnancy after in vitro fertilisation. Australian in vitro fertilisation collaborative group.

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