One versus two embryo transfer after IVF and ICSI: a randomized study

BACKGROUND: The main reason for adverse treatment outcome in assisted repro duction is the high rate of multiple pregnancies. The only strategy to avoi d dizygotic twins is to transfer one embryo at a time. METHODS: A total of 144 women, who had had at least four good quality embryos available after I VF/intracytoplasmic sperm injection (ICSI) and who had no more than one pre vious failed treatment cycle, were randomized to have either one or two emb ryos transferred. The treatment outcomes including those after frozen embry o transfer were compared between these groups. RESULTS: The clinical pregna ncy rate per transfer was 32.4% in the one embryo transfer group and 47.1% in the two embryo transfer group, the difference being not significant. Ele ven twin deliveries (n = 39) occurred in the two embryo transfer group and there was one pair of monozygotic twins in the one embryo transfer group. T he cumulative pregnancy rate per patient after transfer of fresh and frozen embryos was 47.3% in the one embryo transfer group and 58.6% in the two em bryo transfer group. CONCLUSIONS: Our results indicate that among women who have good quality embryos in their first IVF/ICSI, good treatment results can be achieved. They support the idea of changing embryo transfer policy t owards one embryo transfer without any remarkable decrease in the success r ate, while dizygotic twins can be avoided.