The impact of single vs double blastocyst transfer on pregnancy outcomes and the multiple birth rate: a prospective, randomized control trial

Abuzeid, Mostafa I.; Joseph, Sheeba M.; Abuzeid, Yasmine; Salem, Wael; Corrado, Mariana; Ashraf, M.

doi:10.1016/j.fertnstert.2013.07.1734

Cited by 8 publications

(20 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…26 A DET-HH is associated with a higher adjusted pregnancy rate and adjusted LBR irrespective of the number of HQBs available to transfer when compared with SET-H. As expected, however, this was associated with a significantly higher multiple gestation rate of up to 42.5%. Our findings are consistent with a meta-analysis, 11 and a recent randomized study in young patients with good prognosis, 27 but do not support the findings highlighted by a previous retrospective study. 28 When there was no HQB available, proceeding with DET-LL increased pregnancy rate and LBR compared with SET-L (38% vs 15%), but it also increased significantly the multiple gestation rate (31% vs 0%).…”

Section: Discussioncontrasting

confidence: 66%

Adding a low‐quality blastocyst to a high‐quality blastocyst for a double embryo transfer does not decrease pregnancy and live birth rate

Theodorou

Jones

Cawood

et al. 2021

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Introduction:The effect of embryo quality on clinical outcomes of assisted reproductive technology following a double transfer is not well defined, with some studies suggesting that a low-quality embryo transferred with a high-quality embryo decreases the live birth rate (LBR), compared with transferring a single high-quality embryo. Our study examined whether the quality of a second blastocyst transferred affects the outcome, controlling for the number of the available high-quality blastocysts (HQB). Material and methods:A historical cohort study of 2346 fresh blastocyst transfers in a single fertility clinic between 2013 and 2019. The main outcomes were pregnancy, miscarriage, live birth, and multiple gestation rates. Outcomes were compared between single embryo transfers with a high-quality blastocyst (SET-H), double embryo transfers with two HQBs (DET-HH), and transfers with one high-quality and one lowquality blastocyst (DET-HL). Outcomes were also assessed between SET and DET when only low-quality blastocysts were available.Results: With one HQB available, DET-HL increased LBR (adjusted odds ratio [OR] 1.65, 95% CI 1.09-2.49) compared with SET-H, but increased multiple gestation rate (aOR 23.1, 95% CI 3.0-177.6). With two HQBs available, DET-HH was associated with a higher LBR (aOR 1.62, 95% CI 1.28-2.04) and lower miscarriage rate (aOR 0.56, 95% CI 0.40-0.80), but very high twin rate (aOR 49.8, 95% CI 24.3-102.1

show abstract

Section: Discussioncontrasting

confidence: 66%

Adding a low‐quality blastocyst to a high‐quality blastocyst for a double embryo transfer does not decrease pregnancy and live birth rate

Theodorou

Jones

Cawood

et al. 2021

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

show abstract

“…After removing duplicates, 11,847 abstracts were reviewed and 1071 full-text articles were further assessed for eligibility. Finally, 85 articles [ 2 , 11 – 24 , 26 – 31 , 38 – 101 ] involving 339,492 participants, provided extractable data for the quantitative meta-analysis (Fig. 1 ), including 14 RCTs and 71 observational studies; of which, data extracted by two RCTs [ 14 , 20 ] came from four references [ 14 , 20 , 63 , 92 ], and the other two RCT studies [ 16 , 23 ] provided both the results of RCTs and observational cohorts.…”

Section: Resultsmentioning

confidence: 99%

“…Sixty-two studies [ 11 – 20 , 22 – 24 , 26 – 31 , 38 – 41 , 44 , 45 , 47 – 53 , 56 , 58 , 60 – 62 , 64 – 66 , 69 , 71 , 73 – 75 , 77 – 84 , 86 – 91 , 94 , 99 ] demonstrated a reduced LBR after SET (28,529/85,988, 33.2%) than that after DET (113,658/247,116, 46.0%) in a single cycle (OR = 0.78, 95% CI: 0.71–0.85, I 2 = 91%, P < 0.001) (Supplementary Fig. S1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The current issue arising is that for which patient cohorts are SET or DET most suited [ 10 ]. Due to the homogenous population and limited sample size, existing RCTs [ 11 – 24 ] and aggregated meta-analyses [ 4 , 7 ] comparing the number of embryos transferred do not answer the above question. Clinical practice faces challenges of different patient age, cycles, embryo stages, embryo quality ratings etc., and would benefit from direction regarding which strategy would be most beneficial to specific subgroups.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparisons of benefits and risks of single embryo transfer versus double embryo transfer: a systematic review and meta-analysis

Peng

et al. 2022

Reprod Biol Endocrinol

View full text Add to dashboard Cite

Background Evidence referring to the trade-offs between the benefits and risks of single embryo transfer (SET) versus double embryo transfer (DET) following assisted reproduction technology are insufficient, especially for those women with a defined embryo quality or advanced age. Methods A systematic review and meta-analysis was conducted according to PRISMA guidelines. PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov were searched based on established search strategy from inception through February 2021. Pre-specified primary outcomes were live birth rate (LBR) and multiple pregnancy rate (MPR). Odds ratio (OR) with 95% confidence interval (CI) were pooled by a random-effects model using R version 4.1.0. Results Eighty-five studies (14 randomized controlled trials and 71 observational studies) were eligible. Compared with DET, SET decreased the probability of a live birth (OR = 0.78, 95% CI: 0.71–0.85, P < 0.001, n = 62), and lowered the rate of multiple pregnancy (0.05, 0.04–0.06, P < 0.001, n = 45). In the sub-analyses of age stratification, both the differences of LBR (0.87, 0.54–1.40, P = 0.565, n = 4) and MPR (0.34, 0.06–2.03, P = 0.236, n = 3) between SET and DET groups became insignificant in patients aged ≥40 years. No significant difference in LBR for single GQE versus two embryos of mixed quality [GQE + PQE (non-good quality embryo)] (0.99, 0.77–1.27, P = 0.915, n = 8), nor any difference of MPR in single PQE versus two PQEs (0.23, 0.04–1.49, P = 0.123, n = 6). Moreover, women who conceived through SET were associated with lower risks of poor outcomes, including cesarean section (0.64, 0.43-0.94), antepartum haemorrhage (0.35, 0.15-0.82), preterm birth (0.25, 0.21-0.30), low birth weight (0.20, 0.16-0.25), Apgar1 < 7 rate (0.12, 0.02-0.93) or neonatal intensive care unit admission (0.30, 0.14-0.66) than those following DET. Conclusions In women aged < 40 years or if any GQE is available, SET should be incorporated into clinical practice. While in the absence of GQEs, DET may be preferable. However, for elderly women aged ≥40 years, current evidence is not enough to recommend an appropriate number of embryo transfer. The findings need to be further confirmed.

show abstract

“…However, in both studies the majority received cleavage stage embryo transfer (82.0 % (in first complete cycle) and 85.6 % (in all complete cycles), respectively). On the other hand, more studies reported CLBR using blastocyst transfer after a single ovarian stimulation (CLBR ranging from 25.5%-65.3%) [11,17,18], whereas other studies reported similar CLBR but in a freeze all strategy only (CLBR ranging from 55.0%-66.7%) [19][20][21].…”

Section: Discussionmentioning

confidence: 98%

Conditional and cumulative live birth rates after blastocyst transfer

Høyer¹,

Kesmodel

Aagaard³

2021

European Journal of Obstetrics & Gynecology and Reproductiv

View full text Add to dashboard Cite

We aimed to investigate live birth rate (LBR), cumulative live birth rate (CLBR) for consecutive fresh and frozen-thawed in vitro fertilization (IVF) cycles, and CLBR after an entire IVF programme involving multiple ovarian stimulations using blastocyst transfer only. Study design: From January 1 st 2014 to December 31 st 2018, we included women aged 18-45 years who initiated IVF or intracytoplasmic sperm injection at Aagaard Fertility Clinic, Denmark. The primary outcome was live birth, and secondary outcomes were a positive hCG blood test and ongoing pregnancy confirmed by ultrasonography. All proportions were estimated for initiated and transferred cycles with 95 % confidence intervals (CI). We used a conservative strategy, assuming that none of the women who did not return for further treatments had a live birth. Results: 871 women contributed 2236 initiated/1670 transferred fresh and/or frozen-thawed cycles. LBRs for first fresh cycles were 22.8 % (95 %-CI: 19.8À26.0) and 35.7 % (95 %-CI: 31.4À40.2) for initiated and transferred cycles, respectively. LBRs for first frozen-thawed cycles were 30.6 % (95 %-CI: 26.4À35.1) and 31.7 % (95 %-CI: 27.4À36.3) for initiated and transferred cycles, respectively. CLBRs for consecutive cycles were 18.2 % (95 %-CI: 16.2À20.3) for fresh initiated cycles, 29.7 % (95 %-CI: 26.6À32.9) for fresh transferred cycles, 25.5 % (95 %-CI: 22.6À28.5) for frozen-thawed initiated cycles, and 26.4 % (95 %-CI: 23.5À29.6) for frozen-thawed transferred cycles. For 436 women who contributed with an entire IVF programme we found a CLBR of 64.0 % (95 %-CI: 59.3À68.5). Conclusion:Compared to other studies of CLBR after multiple ovarian stimulations using cleavage stage transfer, our study presents a considerable effect in the IVF success rate when using blastocyst transfer only. In a clinical setting, transfer of blastocysts seems to be a viable method.

show abstract

The impact of single vs double blastocyst transfer on pregnancy outcomes and the multiple birth rate: a prospective, randomized control trial

Cited by 8 publications

References 29 publications

Adding a low‐quality blastocyst to a high‐quality blastocyst for a double embryo transfer does not decrease pregnancy and live birth rate

Adding a low‐quality blastocyst to a high‐quality blastocyst for a double embryo transfer does not decrease pregnancy and live birth rate

Comparisons of benefits and risks of single embryo transfer versus double embryo transfer: a systematic review and meta-analysis

Conditional and cumulative live birth rates after blastocyst transfer

Contact Info

Product

Resources

About