Maximizing pregnancy rates and limiting higher-order multiple conceptions by determining the optimal number of embryos to transfer based on quality

Fertility and Sterility
Y HuC Lu

Abstract

To define statistical thresholds for the number of embryos to be transferred to achieve an optimal pregnancy rate and keep higher-order multiple conceptions (pregnancy with more than two fetal sacs with cardiac activity) within an acceptable limit. A retrospective review of patient records. Private practice assisted reproductive technology (ART) facility. Seven hundred fifty-four consecutive patients who underwent IVF-ET from 1994-1996. Embryo grading and score system used on day 3 of embryo transfer. Implantation, pregnancy, and multiple conception rates. For women < or =35 years old, transfer of up to four poor-quality, two fair-quality, or two good-quality embryos is optimal to eliminate any risk of higher-order multiple pregnancies. Transfer of four poor-quality, three fair-quality, or two good-quality embryos is recommended for women 36 to 39 years old. In women who are > or =40 years old, five embryos need to be transferred regardless of embryo quality. The mean cumulative embryo score can be used as a reference to determine an optimal number of embryos to transfer and to predict pregnancy outcome.

Citations

Oct 26, 2005·Journal of Assisted Reproduction and Genetics·Tiffany L RhodesWilliam R Boone
Mar 7, 2007·Journal of Assisted Reproduction and Genetics·Patricia FauqueCatherine Patrat
Jul 17, 2007·Journal of Assisted Reproduction and Genetics·Martin WildingBrian Dale
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