2 INSTEAD OF 3 EMBRYO-TRANSFER IN IN-VITRO FERTILIZATION

The rational of transferring two instead of three embryos was studied through 468 in-vitro fertilization (IVF) treatment cycles in 287 coupl es, The quality of 1224 embryos was determined according to the fragme ntation rate and the morphology as good (A) and poor (B). The influenc e of the number of embryos transferred (two or three) on the pregnancy rate when the same quality or combinations of good and poor quality e mbryos transferred was examined, When only good quality embryos were t ransferred the pregnancy rates in double (AA) and triple (AAA) embryo transfer were 40.5 (17/42) and 42.9% (30/70) respectively (not signifi cant), When only poor quality embryos were transferred, the pregnancy rates in double (BE) and triple (BBB) embryo transfers were 11.0% (11/ 100) and 22.9% (16/70) respectively (P < 0.001), On the other hand, wh en good and poor quality embryos were transferred together as AB in do uble and as AAB and ABB in triple embryo transfer, the pregnancy rates were 36.8 (14/38) and 39.9% (59/148) respectively (not significant), There was no difference in the miscarriage rate between double and tri ple embryo transfers; 16.7 and 18.1% respectively, The multiple pregna ncy rate was 14.3% for double embryo transfers and 32.4% for triple em bryo transfers (P < 0.001). This study demonstrates that if there is a t least one good quality embryo available for transfer, then double in stead of triple embryo transfer will not yield a significantly lower p regnancy rate. The influence of the number of embryos transferred on t he pregnancy rate became significant when only poor quality embryos we re transferred. In conclusion, as long as at least one good quality em bryo is available for transfer, we may consider the transfer of double instead of triple embryos.