Effect of double embryo transfer derived from autologous frozen oocytes on multiple pregnancy rates and presentation of success rates stratified for age at retrieval Badeghiesh et al. Single vs. double ET with frozen oocytes

The purpose of the present study was to examine the effect of single embryo transfer (SET) in assisted reproductive technology (ART) on the reduction of the multiple pregnancy rate. We also estimated the monozygotic (MZ) twinning rates according to the SET diffusion indirectly. A reverse sigmoid curve was assumed and examined using nationwide data of SET from 2007 to 2009 in Japan. The multiple pregnancy rate decreased almost linearly where the SET pregnancy rate was between about 40% and 80% of regression approximation. The linear approximation overestimated multiple pregnancy rates in an early period and underestimated multiple pregnancy rates in the final period. The multiple pregnancy rate seemed to be influenced by the improvement of the total pregnancy rate of ART in the early period and by the MZ twinning after SET in the final period. The estimated MZ twinning rate after SET was around 2%.

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2017–2018 Assisted Reproduction Cost Analysis Performance Indexes: Lombardy County Case Study

Frontiers in Reproductive Health ◽

10.3389/frph.2021.693715 ◽

2021 ◽

Vol 3 ◽

Author(s):

Paolo Emanuele Levi-Setti ◽

Andrea Busnelli ◽

Annalisa Bodina ◽

Roberto De Luca ◽

Giulia Scaravelli

Keyword(s):

Embryo Transfer ◽

Multiple Pregnancy ◽

Economic Cost ◽

Oocyte Retrieval ◽

Delivery Rate ◽

Success Rates ◽

Performance Indexes ◽

Significant Difference ◽

The Mean ◽

Lost To Follow Up

Objective: The aim of the present study was to analyze the IVF success rates and the economic cost per delivery in all the public funded IVF Units in Lombardy in the 2017–2018 period and to assess any significant difference in ART outcomes among the enrolled centers.Methods: Analysis of costs for the 2017 and 2018 fresh transfer delivery rate (DR) and Cumulative delivery rate (CDR) considering both fresh and frozen cycles were extracted from the ART Italian Registry on oocytes retrievals, fresh and frozen embryos and oocytes embryo transfer performed in 22 Lombardy IVF Units.Results: In 2017, 29,718 procedures were performed, resulting in 4,543 pregnancies and 3,253 deliveries. In 2018, there were 29,708 procedures, 4,665 pregnancies and 3,348 deliveries. Pregnancies lost to follow up were 5.0% with a (range of 0–67.68%) in 2017 and 3.4% (range of 0–45.1%) in 2018. The cost reimbursement for the cycles were €2,232 ($2,611) for oocyte retrieval and €2,194 ($2,567) for embryo transfer, excluding ovarian stimulation therapy and luteal phase support. 19.33 (5.80). The DR was 13.23 ± 5.69% (range 2.86–29.11%) in 2017 and 19.33 ± 5.80% in 2018 (range 11.82–34.98 %) and the CDR was 19.86 ± 9.38% (range 4.43–37.88%) in 2017 and 21.32 ± 8.84% (range 4.24–37.11%). The mean multiple pregnancy delivery rate (MDR) was 11.08 ± 5.55% (range 0.00–22.73%) in 2017 and 10.41 ± 4.99% (range 1.33–22.22%) in 2018. The mean CDR cost in euros was 26,227 ± 14,737 in 2017 and 25,018 ± 16,039 in 2018. The mean CDR cost among centers was 12,480 to 76,725 in 2017 and 12,973 to 86,203 in 2018.Conclusions: Our findings show impressive differences in the DR and CDR among centers and the importance of cryopreservation in patients' safety and economic cost reduction suggesting the formulation of specific KPI's (Key performance indexes) and minimal performance indexes (PI) as a basis for the allocation of public or insurance resources. In particular, the reduction of multiple pregnancy rates costs, may lead to a more widespread use of ART even in lower resources countries.

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Assessment of the pregnancy rates using sequential day 3 and day 5 embryo transfer in IVF/ ICSI patients

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210731 ◽

2021 ◽

Vol 10 (3) ◽

pp. 1042

Author(s):

Priti Agrawal ◽

Rishi Agrawal ◽

Anandi Lobo

Keyword(s):

Embryo Transfer ◽

Formation Rate ◽

Multiple Pregnancy ◽

Test Tube ◽

Pregnancy Rates ◽

Clinical Pregnancy ◽

Fertilization Rates ◽

Cycle Cancellation ◽

Viable Embryo ◽

Selection Of

Background: To assess the pregnancy rates using sequential day 3 and day 5 embryo transfer in IVF/ ICSI patients.Methods: This prospective study was conducted in Aarogya Hospital and test tube baby Centre, Raipur from 1st January 2013 to 30th November 2019. Total 100 patients undergoing IVF/ICSI in the study period were offered sequential transfer.Results: Our fertilization rates were 80% with 85.7% grade I embryos on day 3. Blastocyst formation rate was 71.42%. Cycle cancellation rates were nil. Clinical pregnancy rates per retrieval cycle were 50% and implantation rates were 24% with acceptable multiple pregnancy rates of 12%.Conclusions: We advocate that this technique is useful in all patients having good quality embryos in adequate number for double transfer as this optimizes the chance of selection of the most viable embryo for transfer which is probably the key for a successful IVF program.

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Advantages of the two-step embryo transfer strategy in human IVF/ICSI cycles

Zygote ◽

10.1017/s096719941100058x ◽

2011 ◽

Vol 21 (1) ◽

pp. 77-83 ◽

Cited By ~ 2

Author(s):

Chadi Yazbeck ◽

Nadia Ben Jamaa ◽

André Hazout ◽

Paul Cohen-Bacrie ◽

Anne-Marie Junca ◽

...

Keyword(s):

Embryo Transfer ◽

Live Birth ◽

Birth Rate ◽

Multiple Pregnancy ◽

Live Birth Rate ◽

Pregnancy Rates ◽

Group 2 ◽

Human Ivf ◽

Group 1

SummaryThe aim of this study was to evaluate the advantages of the two-step embryo transfer (ET) strategy combining a day 2/3 ET with a day 5/6 blastocyst transfer. In an observational comparative study, 400 infertile women were enrolled from two assisted reproductive technology (ART) units according to inclusion criteria: age below 42 years and at least three embryos obtained on day 2 thus allowing an extended in vitro culture. Two groups were defined according to the ET strategy adopted: group 1 had a two-step ET; and group 2 had a day 2/3 ET with (subgroup 2a) or without (subgroup 2b) blastocysts cryopreserved on day 5/6. Live birth rate was significantly higher in group 1 than in subgroups 2a and 2b (36.5% versus 29.4% and 13.4%, respectively; p < 10−3). Multiple pregnancy rates were comparable between groups. After adjusting on major prognostic factors, the two-step ET strategy was still associated with a significantly higher live birth rate than the day 2/3 ET (OR = 2.23; 95% CI: 1.32–3.77). The two-step ET provides better live birth rates than the cleavage-stage ET. It does not increase multiple pregnancy rates if the number of embryos transferred is limited. It also prevents cycle loss when embryos fail to develop into blastocysts.

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O-199 Proof of concept: implantation window must be wider than proposed. Report of seven twins after asynchronous double embryo transfer

Human Reproduction ◽

10.1093/humrep/deab128.010 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

A. Gosálvez Vega ◽

M. Rodriguez Mazaira ◽

N. Martin Fernandez ◽

M. Iglesias Nuñez ◽

M Brandt ◽

...

Keyword(s):

Embryo Transfer ◽

Developmental Stages ◽

Multiple Pregnancy ◽

Good Prognosis ◽

Human Embryos ◽

Proof Of Concept ◽

Implantation Window ◽

Study Results ◽

Simultaneous Transfer ◽

Double Embryo Transfer

Abstract Study question Can simultaneous transfer of two embryos that were cryopreserved at different stages (D3 and Blastocyst) be appropriate to enhance success in women with more than three failed embryo transfers? Summary answer Double asynchronous embryo transfer offered excellent results in RIF. Unexpectedly high twin rate suggests that embryo-endometrium synchrony is overemphasized. Implantation window must be wider. What is known already Transcriptomic signature of the endometrium has been investigated in the last few years trying to understand the best moment for embryo implantation. Nevertheless, the optimal period has not been well established yet in humans. Simultaneous transfer of two human embryos at different developmental stages (D3 and Blastocyst) on Day 4 was proposed to help couples who have had RIF. Study design, size, duration Observational case-control study. From April 2016 to January 2021, we offered double asynchronous embryo transfer only after Recurrent Implantation Failure (RIF). Two requirements were necessary: 1) Double embryo transfer was acceptable by the couple due to poor reproductive outcome. 2) Availability of two embryos cryopreserved at different stage (D3 and Blastocyst). Results were compared with good prognosis patients (all patients under 35 years in that period who had elected to transfer two day 3 cryopreserved embryos). Participants/materials, setting, methods Forty-five patients accepted to participate in the study. Results were compared with all patients (237) under 35 years where two D3 thawed embryos were transferred. All cases received same protocol (oral estradiol 6mg/d or vaginal estradiol 4mg/d until ultrasound showed endometrial growth) LH, P4 and E2 were monitored in all patients to detect spontaneous LH surge. All cases received transvaginal micronized progesterone 800 mg/d. Embryo transfers were ultrasound guided and Wallace Embryosure catheter was employed. Main results and the role of chance Limitations, reasons for caution Multiple pregnancy rate was unacceptably high. Therefore, it should not be suggested for good prognosis couples where single embryo transfer is clearly advidsed. Our main limitation was the combination of D3 embryos with blastocysts. The retrospective design make the results to be considered as a proof of concept. Wider implications of the findings Double asynchronic embryo transfer can offer new insights in the understanding of human implantation. The concept of implantation window is clearly challenged. Aiming to the center of the window is fine, but we still dońt know how wide is that center. Trial registration number not applicable

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Why are multiple pregnancy rates and single embryo transfer rates so different globally, and what do we do about it?

Fertility and Sterility ◽

10.1016/j.fertnstert.2020.09.003 ◽

2020 ◽

Vol 114 (4) ◽

pp. 680-689

Author(s):

G. David Adamson ◽

Robert J. Norman

Keyword(s):

Embryo Transfer ◽

Multiple Pregnancy ◽

Single Embryo Transfer ◽

Pregnancy Rates ◽

Transfer Rates

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Stolen Twin: Fascination and Curiosity/Twin Research Reports: Evolution of Sleep Length; Dental Treatment of Craniopagus Twins; Cryopreserved Double Embryo Transfer; Gender Options in Multiple Pregnancy/Current Events: Appendectomy in One Twin; Autistic Twin Marathon Runners; 3D Facial Recognition; Twin Biathletes

Twin Research and Human Genetics ◽

10.1017/thg.2013.88 ◽

2014 ◽

Vol 17 (1) ◽

pp. 56-61 ◽

Cited By ~ 1

Author(s):

Nancy L. Segal

Keyword(s):

Embryo Transfer ◽

Dental Treatment ◽

Facial Recognition ◽

Multiple Pregnancy ◽

Societal Implications ◽

Marathon Runners ◽

Twin Research ◽

Current Events ◽

Sleep Length ◽

Double Embryo Transfer

The story of her allegedly stolen twin brother in Armenia is recounted by a ‘singleton twin’ living in the United States. The behavioral consequences and societal implications of this loss are considered. This case is followed by twin research reports on the evolution of sleep length, dental treatment of craniopagus conjoined twins, cryopreserved double embryo transfer (DET), and gender options in multiple pregnancy. Current events include the diagnosis of appendectomy in one identical twin, the accomplishments of autistic twin marathon runners, the power of three-dimensional (3D) facial recognition, and the goals of twin biathletes heading to the 2014 Sochi Olympics in Russia.

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Elective single versus double embryo transfer: live birth outcome and patient acceptance in a prospective randomised trial

Reproduction Fertility and Development ◽

10.1071/rd13412 ◽

2015 ◽

Vol 27 (5) ◽

pp. 794 ◽

Cited By ~ 5

Author(s):

Nicolás Prados ◽

Rocío Quiroga ◽

Cinzia Caligara ◽

Myriam Ruiz ◽

Víctor Blasco ◽

...

Keyword(s):

Embryo Transfer ◽

Live Birth ◽

Controlled Trial ◽

Randomised Trial ◽

Multiple Pregnancy ◽

Multiple Births ◽

Delivery Rate ◽

Patient Acceptance ◽

Increased Risk ◽

Double Embryo Transfer

The purpose of this study was to determine which strategy of embryo transfer has a better trade-off in live birth delivery rate versus multiple pregnancy considering patient acceptance: elective single embryo transfer (eSET) or elective double embryo transfer (eDET). In all, 199 women <38 years of age undergoing their first IVF treatment in a private centre were included in a prospective open-label randomised controlled trial. Patients were randomised into four groups: (1) eSET on Day 3; (2) eSET on Day 5; (3) eDET on Day 3; and (4) eDET on Day 5. Per patient, main analysis included acceptance of assigned group, as well as multiple and live birth delivery rates of the fresh cycle. Secondary analysis included the rates of subsequent cryotransfers and the theoretical cumulative success rate. Of 98 patients selected for eSET, 40% refused and preferred eDET. The live birth delivery rate after eDET was significantly higher after eDET versus eSET (65% vs 42%, respectively; odds ratio = 1.6, 95% confidence interval 1.1–2.1). No multiple births were observed after eSET, compared with 35% after eDET. Although live birth delivery is higher with eDET, the increased risk of multiple births is avoided with eSET. Nearly half the patients refused eSET even after having been well informed about its benefits.

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