ABSTRACT
To compare the pregnancy outcomes after two embryos versus three embryos transfers [ETs] in women undergoing in vitro fertilization [IVF] intracytoplasmic sperm injection [ICSI] cycles. This retrospective study was performed on three hundred eighty seven women with primary infertility and with at least one fresh embryo in good quality in order to transfer at each IVF/ICSI cycle, from September 2006 to June 2010. Patients were categorized into two groups according to the number of ET as follows: ET2 and ET3 groups, indicating two and three embryos were respectively transferred. Pregnancy outcomes were compared between ET2 and ET3 groups. Chi square and student t tests were used for data analysis. Clinical pregnancy and live birth rates were similar between two groups. The rates of multiple pregnancies were 27 and 45.2% in ET2 and ETS groups, respectively. The rate of multiple pregnancies in young women was significantly increased when triple instead of double embryos were transferred. Logistic regression analysis indicated two significant prognostic variables for live birth that included number and quality of transferred embryos; it means that the chance of live birth following ICSI treatment increased 3.2-fold when the embryo with top quality [grade A] was transferred, but the number of ET had an inverse relationship with live birth rate; it means that probability of live birth in women with transfer of two embryos was three times greater than those who had three ET. Due to the difficulty of implementation of the elective single-ET technique in some infertility centers in the world, we suggest transfer of double instead of triple embryos when at least one good quality embryo is available for transfer in women aged 39 years or younger. However, to reduce the rate of multiple pregnancies, it is recommended to consider the elective single ET strategy
ABSTRACT
The objective was to evaluate whether extending the embryo culture period from 2 to 3 days would yield a more optimal selection of viable embryos, thereby increasing the pregnancy rate. We have retrospectively analyzed pregnancy rates in the patients who had embryo transfer either on day 2 [582 patients] or on day 3 [387 patients] post-insemination over a 10-month period. The relationship between the quality score of day 2 and day 3 embryos and their respective pregnancy rates was also analyzed. The demographic and clinical characteristics were similar in both groups. Embryos transferred on day 2 or day 3, were similar morphologically and we found no difference in the distribution of grades between patients who became pregnant and those who failed to become pregnant. Pregnancy rates were slightly higher in patients who had embryo transfer on day 3 [40.72%] than patients who had transferred on day 2 [38.96%], but this difference was not significant. proportion of embryos with 2-3 cells, four cells, and 5-7 cells, which selected for transfer, showed significant difference between day 2 and day 3 [p<0.05]. There was also significant difference between pregnant and non-pregnant women based on embryo cell numbers on day two [p<0.011]. Extending the embryo culture period from 2 to 3 days had no adverse effect on pregnancy rate. Embryo transfer could be done on days 2 or 3 according to the convenience of the patient and the medical team