Is blastocyst transfer useful as an alternative treatment for patients with multiple in vitro fertilization failures?

Objective: To determine whether blastocyst transfer is of benefit to patien ts with multiple IVF failures. Design: Retrospective cohort study. Setting: The George Washington University Medical Center. Patient(s): Patients undergoing IVF between October 1, 1997, and November 3 0, 1998, who had previously undergone three or more unsuccessful IVF cycles . Patients who had at least three embryos at the 8- to 12-cell stage availa ble on day 3 were eligible for the study. Intervention(s): Patients were given the option of day 3 ET (group A) or bl astocyst transfer (group B). Main Outcome Measure(s): Blastocyst-formation rate, clinical pregnancy rate (PR) per tra nsfer, and implantation rate per transfer. Result(s): Groups A and B were similar in terms of age, the number of previ ous failed IVF cycles, fertilization rate, and the number of fertilized ooc ytes per cycle. The blastocyst-formation rate was 51.0%. Clinical pregnancy and implantation rates per transfer were statistically significantly highe r in the blastocyst-transfer group. There were no multiple pregnancies afte r blastocyst transfer. Conclusion: Blastocyst transfer increases implantation rates and PRs in pat ients with multiple failed IVF cycles, without increasing the risk of multi ple pregnancy. (C) 1999 by American Society for Reproductive Medicine.