Objective: To select patients for day 3 vs. day 5 embryo transfer.
Design: Retrospective analysis of assisted reproduction technology (ART) cy
cles comparing outcomes of day 3 and day 5 transfers.
Setting: ART program of Brigham and Women's Hospital.
Patient(s): Patients with day 3 or day 5 embryo transfers (n = 221 and 141,
respectively).
Intervention(s): Cycles with eight or more zygotes were stratified by the n
umber of eight-cell embryos available on day 3 (none, one or two, or three
or more).
Main Outcome Measure(s): Number of blastocysts, implantation rates, ongoing
pregnancy rates, and number of fetal heart beats.
Result(s): With no eight-cell embryos on day 3, 0% and 33% pregnancies resu
lted from day 5 vs. day 3 transfers. With one or two eight-cell embryos on
day 3, ongoing and high order multiple rates were not different between day
3 and day 5 transfers. With three or more eight-cell embryos, day 5 transf
er resulted in a decrease in multiple gestations but no difference in ongoi
ng pregnancy rates compared with day 3 transfer.
Conclusion(s): With no eight-cell embryos on day 3, a day 3 transfer is war
ranted. With one or two eight-cell embryos, any benefit of day 5 transfer a
ppears to be equivocal. With three or more eight-cell embryos, day 5 transf
er is recommended. (C) 2000 by American Society for Reproductive Medicine.