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The impact of the embryo quality on the risk of multiple pregnancies

Published online by Cambridge University Press:  25 July 2014

Daniela Paes de Almeida Ferreira Braga ,
Amanda S. Setti ,
Rita de Cássia S. Figueira ,
Assumpto Iaconelli Jr  and
Edson Borges Jr
Daniela Paes de Almeida Ferreira Braga
Affiliation:
Fertility–Centro de Fertilização Assistida, 4545 Av. Brigadeiro Luis, São Paulo 01401–002, SP, Brazil. Instituto Sapientiae–Centro de Pesquisa e Educação em Reprodução Assistida, 62 Rua Vieira Maciel, São Paulo 04203–040, SP, Brazil.
Amanda S. Setti
Affiliation:
Fertility–Centro de Fertilização Assistida, 4545 Av. Brigadeiro Luis, São Paulo 01401–002, SP, Brazil. Instituto Sapientiae–Centro de Pesquisa e Educação em Reprodução Assistida, 62 Rua Vieira Maciel, São Paulo 04203–040, SP, Brazil.
Rita de Cássia S. Figueira
Affiliation:
Fertility–Centro de Fertilização Assistida, 4545 Av. Brigadeiro Luis, São Paulo 01401–002, SP, Brazil.
Assumpto Iaconelli Jr
Affiliation:
Fertility–Centro de Fertilização Assistida, 4545 Av. Brigadeiro Luis, São Paulo 01401–002, SP, Brazil.
Edson Borges Jr*
Affiliation:
Fertility–Centro de Fertilização Assistida, 4545 Av. Brigadeiro Luis Antônio, São Paulo 01401–002, SP, Brazil. Instituto Sapientiae–Centro de Pesquisa e Educação em Reprodução Assistida, 62 Rua Vieira Maciel, São Paulo 04203–040, SP, Brazil.
*
All correspondence to: Edson Borges Jr. Fertility–Centro de Fertilização Assistida, 4545 Av. Brigadeiro Luis Antônio, São Paulo 01401–002, SP, Brazil. Fax: +55 11 3018 8181. e-mail: edson@fertility.com.br
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Summary

The aim of the present study was to determine the chance of pregnancy and the risk of multiple pregnancies taking into account the number and quality of transferred embryos in patients >36 years old or ≤36 years old. For this study, 1497 patients undergoing intra-cytoplasmic sperm injection (ICSI) cycles in a private assisted reproduction centre were split into groups according to the number and quality of the transferred embryos on the third or fifth day of development. The pregnancy rate and multiple pregnancy rate were compared between the embryo quality groups in patients <36 years old or ≥36 years old. In patients <36 years old, for the day 3 embryo transfer, no significant difference was noted in the pregnancy rate when the groups were compared. However the multiple pregnancy rate was increased by the transfer of an extra low-quality embryo (17.1 versus 28.2%, P = 0.020). For day 5 embryo transfer, the transfer of an extra blastocyst significantly increased the pregnancy rate (36.0 versus 42.4%, P < 0.001) and the multiple pregnancy rate (4.4 versus 16.9%, P < 0.001). In older patients, no significant difference was noted in the pregnancy rate when the groups were compared. However, when an extra low-quality embryo was transferred, a significantly increased rate of multiple pregnancies was observed for day 3 (18.2 versus 26.4%, P = 0.049) and day 5 embryo transfers (5.2 versus 16.1%, P < 0.001). In conclusion, the transfer of an extra low-quality embryo may increase the risk of a multiple pregnancy. In younger patients, the transfer of an extra low-quality blastocyst may also increase the chance of pregnancy.

Keywords

Assisted reproductionEmbryo qualityEmbryo transferMultiple pregnancy
Type
Research Article
Information
Zygote , Volume 23 , Issue 5 , October 2015 , pp. 662 - 668
Copyright
Copyright © Cambridge University Press 2014 

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References

ACOG (2005). ACOG Committee Opinion #324: Perinatal risks associated with assisted reproductive technology. Obstet. Gynecol. 106, 1143–6.CrossRefGoogle Scholar
Adashi, E.Y., Barri, P.N., Berkowitz, R., Braude, P., Bryan, E., Carr, J., et al. (2003). Infertility therapy-associated multiple pregnancies (births): an ongoing epidemic. Reprod. Biomed. Online. 7, 515–42.CrossRefGoogle ScholarPubMed
Blake, D.A., Farquhar, C.M., Johnson, N. & Proctor, M. (2007). Cleavage stage versus blastocyst stage embryo transfer in assisted conception. Cochrane Database Syst. Rev. 4, CD002118.Google Scholar
Bonetti, T.C., Melamed, R.M., Braga, D.P., Madaschi, C., IaconelliA., Jr. A., Jr., Pasqualotto, F.F. & Borges, E. Jr (2008). Assisted reproduction professionals’ awareness and attitudes towards their own IVF cycles. Hum. Fertil. (Camb.) 11, 254–8.CrossRefGoogle ScholarPubMed
Criniti, A., Thyer, A., Chow, G., Lin, P., Klein, N. & Soules, M. (2005). Elective single blastocyst transfer reduces twin rates without compromising pregnancy rates. Fertil. Steril. 84, 1613–9.CrossRefGoogle ScholarPubMed
Gardner, D. & Schoolcraft, W. (1999). In-vitro culture of human blastocysts. In: Jansen, R. & Carnforth, M.D. (eds), Towards Reproductive Certainty: Fertility and Genetics beyond 1999. Carnforth, UK: Parthenon Press, pp. 378–388.Google Scholar
Gelbaya, T.A., Tsoumpou, I. & Nardo, L.G. (2010). The likelihood of live birth and multiple birth after single versus double embryo transfer at the cleavage stage: a systematic review and meta-analysis. Fertil. Steril. 94, 936–45.CrossRefGoogle Scholar
Gleicher, N., Campbell, D.P., Chan, C.L., Karande, V., Rao, R., Balin, M. & Pratt, D. (1995). The desire for multiple births in couples with infertility problems contradicts present practice patterns. Hum. Reprod. 10, 1079–84.CrossRefGoogle ScholarPubMed
Hill, M.J., Richter, K.S., Heitmann, R.J., Graham, J.R., Tucker, M.J., DeCherney, A.H., Browne, P.E. & Levens, E.D. (2013). Trophectoderm grade predicts outcomes of single-blastocyst transfers. Fertil. Steril. 99, 1283–1289e1.CrossRefGoogle ScholarPubMed
Ludwig, M., Schopper, B., Katalinic, A., Sturm, R., Al-Hasani, S. & Diedrich, K. (2000). Experience with the elective transfer of two embryos under the conditions of the german embryo protection law: results of a retrospective data analysis of 2573 transfer cycles. Hum. Reprod. 15, 319–24.CrossRefGoogle ScholarPubMed
Maheshwari, A., Griffiths, S. & Bhattacharya, S. (2011). Global variations in the uptake of single embryo transfer. Hum. Reprod. Update 17, 107–20.CrossRefGoogle ScholarPubMed
McLernon, D.J., Harrild, K., Bergh, C., Davies, M.J., de Neubourg, D., Dumoulin, J.C.et al. (2010). Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials. BMJ 341, c6945.CrossRefGoogle ScholarPubMed
Ola, B. & Li, T.C. (2006). Implantation failure following in-vitro fertilization. Curr. Opin. Obstet. Gynecol. 18, 440–5.CrossRefGoogle ScholarPubMed
Olivennes, F. (2000). Avoiding multiple pregnancies in ART. Double trouble: yes a twin pregnancy is an adverse outcome. Hum. Reprod. 15, 1663–5.CrossRefGoogle ScholarPubMed
Olivennes, F. & Frydman, R. (1998). Friendly IVF: the way of the future? Hum. Reprod. 13, 1121–4.CrossRefGoogle ScholarPubMed
Ontario, H.Q. (2006). In vitro fertilization and multiple pregnancies: an evidence-based analysis. Ont. Health Technol. Assess. Ser. 6, 1–63.Google Scholar
Palermo, G., Joris, H., Devroey, P. & Van Steirteghem, A.C. (1992). Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet 340, 17–8.CrossRefGoogle ScholarPubMed
Pandian, Z., Bhattacharya, S., Ozturk, O., Serour, G. & Templeton, A. (2009). Number of embryos for transfer following in-vitro fertilisation or intra-cytoplasmic sperm injection. Cochrane Database Syst. Rev. 2, CD003416.Google Scholar
Pandian, Z., Marjoribanks, J., Ozturk, O., Serour, G. & Bhattacharya, S. (2013). Number of embryos for transfer following in vitro fertilisation or intra-cytoplasmic sperm injection. Cochrane Database Syst. Rev. 7, CD003416.Google Scholar
Papanikolaou, E.G., Kolibianakis, E.M., Tournaye, H., Venetis, C.A., Fatemi, H., Tarlatzis, B. & Devroey, P. (2008). Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis. Hum. Reprod. 23, 91–9.CrossRefGoogle ScholarPubMed
Pennings, G. (2000). Avoiding multiple pregnancies in ART: multiple pregnancies: a test case for the moral quality of medically assisted reproduction. Hum. Reprod. 15, 2466–9.CrossRefGoogle ScholarPubMed
Reynolds, M.A., Schieve, L.A., Jeng, G. & Peterson, H.B. (2003). Does insurance coverage decrease the risk for multiple births associated with assisted reproductive technology? Fertil. Steril. 80, 16–23.CrossRefGoogle ScholarPubMed
Stephen, E.H. & Chandra, A. (2006). Declining estimates of infertility in the United States: 1982–2002. Fertil. Steril. 86, 516–23.CrossRefGoogle ScholarPubMed
Stillman, R.J., Richter, K.S., Banks, N.K. & Graham, J.R. (2009). Elective single embryo transfer: a 6-year progressive implementation of 784 single blastocyst transfers and the influence of payment method on patient choice. Fertil. Steril. 92, 1895–906.CrossRefGoogle ScholarPubMed
Styer, A.K., Wright, D.L., Wolkovich, A.M., Veiga, C. & Toth, T.L. (2008). Single-blastocyst transfer decreases twin gestation without affecting pregnancy outcome. Fertil. Steril. 89, 1702–8.CrossRefGoogle ScholarPubMed
te Velde, E.R. & Pearson, P.L. (2002). The variability of female reproductive ageing. Hum. Reprod. Update 8, 141–54.CrossRefGoogle ScholarPubMed
Van den Abbeel, E., Balaban, B., Ziebe, S., Lundin, K., Cuesta, M.J., Klein, B.M., Helmgaard, L. & Arce, J.C. (2013). Association between blastocyst morphology and outcome of single-blastocyst transfer. Reprod. Biomed. Online 27, 353–61.CrossRefGoogle ScholarPubMed
Westergaard, C.G., Byskov, A.G. & Andersen, C.Y. (2007). Morphometric characteristics of the primordial to primary follicle transition in the human ovary in relation to age. Hum. Reprod. 22, 2225–31.CrossRefGoogle ScholarPubMed
WHO (2010). WHO Laboratory Manual for the Examination and Processing of Human Semen. Geneva, Switzerland: World Health Organization.Google Scholar