Dramatic declines in implantation and pregnancy rates in patients who undergo repeated cycles of in vitro fertilization with blastocyst transfer after one or more failed attempts

Objective: To compare the outcome of second and third cycles of in vitro fe rtilization. with blastocyst transfer to the outcome of first attempts at I VF with blastocyst transfer. Design: Retrospective study. Setting: Private ART center. Patient(s): Three hundred and four patients undergoing treatment with in vi tro fertilization with blastocyst transfer, 87 of which underwent at least one cycle of re-treatment after failing to achieve pregnancy in their first cycle. Intervention(s): Bipronucleate oocytes were grown for up to 144 hours and s ubsequently transferred when at least one embryo attained the expanded blas tocyst stage. Main Outcome Measure(s): Pregnancy and implantation rates. Result(s): Pregnancy rates per retrieval were significantly higher for pati ents undergoing their first cycle of in vitro fertilization with blastocyst transfer (36%) compared to those undergoing their second (19%) or their th ird (9%) cycles of treatment. Implantation rates per embryo were also highe r for first cycles of in vitro fertilization with blastocyst transfer (30%) compared to second (18%) or third cycles (8%). Conclusion(s): Pregnancy and implantation rates decline dramatically in rep eated cycles of in vitro fertilization with blastocyst transfer following o ne or more unsuccessful cycles of in vitro fertilization with blastocyst tr ansfer. (Fertil Steril(R) 2001,76:538-42. (C) 2001 by American Society for Reproductive Medicine).