An additional poor-quality embryo for transfer: an impact on ART program outcome
DOI:
https://doi.org/10.37800/RM.3.2024.65-72Keywords:
single embryo transfer (SET), double embryos transfer (DET), blastocyst, assisted reproductive technology (ART)Abstract
Relevance: Nowadays, multiple pregnancies are considered an adverse outcome associated with ART (Assisted Reproductive Technology), leading to high rates of maternal and perinatal mortality and morbidity. The number of embryos transferred should be minimized to reduce the risks of multiple pregnancies. Given the high frequency of live births after blastocyst transfer, many ART clinics are moving away from using DET (Double Embryo Transfer) in favor of SET (Single Embryo Transfer).
In clinical practice, there are cases where two blastocysts are transferred, one of good quality and one of poor quality. This approach may increase the live birth rate (LBR) at a low frequency of multiple pregnancies.
The study aimed to determine the impact of transferring a poor-quality blastocyst and slow-growing embryos alongside a good-quality blastocyst on pregnancy outcomes.
Materials and Methods: This study analyzed data from patients under 34 years old who underwent IVF-ICSI programs from January 2015 to December 2020. The outcomes of "fresh" transfers on the fifth day of development were compared among the following groups: 1 good-quality blastocyst (SET-GQ), 1 good-quality blastocyst + 1 poor-quality blastocyst (GQ+PQ), 1 good-quality blastocyst + 1 early blastocyst or morula (GQ+EBM), and 2 good-quality blastocysts (DET-GQ) – the control group.
Results: No significant difference was found in LBR when comparing the SET-GQ group with the GQ+PQ and GQ+EBM groups. The frequency of multiple pregnancies (2 or more fetuses at 6 weeks) was significantly lower in the SET-GQ group compared to the GQ+PQ and GQ+EBM groups.
Conclusion: Adding a poor-quality embryo does not increase the LBR but significantly increases the multiple pregnancies rate.
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