Mj. Gorrill et al., Multiple gestations in assisted reproductive technology: Can they be avoided with blastocyst transfers?, AM J OBST G, 184(7), 2001, pp. 1471-1477
OBJECTIVE: Blastocysts are advanced-stage embryos with high implantation po
tential; theoretically, limited numbers of blastocysts can be used for embr
yo transfer to achieve good pregnancy rates with low multiple pregnancy rat
es. Clinical outcomes of a newly implemented blastocyst transfer program we
re evaluated.
STUDY DESIGN: This study is a retrospective analysis of 553 blastocyst tran
sfer cycles performed by a university-based in vitro fertilization program;
risk factors associated with multiple gestations were analyzed.
RESULTS: An average of 2.2 embryos were used for embryo transfer. The overa
ll clinical pregnancy rate per embryo transfer was 45.1%; multiple gestatio
n, twin, and triplet rates were 40.9%, 36.5%, and 4.3%, respectively. Multi
ple gestations increased significantly (1) when embryo transfer was done on
day 5, (2) when greater than or equal to2 blastocysts were present on day
5, and (3) when maternal age was less than or equal to 30 years.
CONCLUSION: In spite of a conservative approach to the number of blastocyst
s used for embryo transfer, the overall multiple pregnancy rate was high, a
nd triplet pregnancies did occur.