Alternative Embryo Transfer on Day 3 or Day 5 for Reducing the Risk of Multiple Gestations

Authors

Hye-Gyun Yoon, Maria Women’s Hospital, Seoul, Kore
San-Hyun Yoon, Maria Women’s Hospital, Seoul, Kore
Weon-Young Son, Maria Women’s Hospital, Seoul, Kore
Jong Gug Kim, USDA,ARS, Roman L. HruskaU.S. Meat Animal Research Center
Kyung-Soon Im, Seoul National University
Jin-Ho Lim, Maria Women’s Hospital, Seoul, Kore

Date of this Version

2001

Document Type

Article

Citation

Journal of Assisted Reproduction and Genetics, Vol. 18, No. 5, 2001

Comments

U.S. Government Work

Abstract

Purpose: This study was carried out to reduce the possibility of high-order multiple gestations and the failure of embryo transfer by determining their replacement date based on the number and quality of 2-day embryos.

Methods: All zygotes were cocultured with cumulus cells in 10 ¹l of YS medium containing 10% human follicular fluid (hFF) for 48 or 96 hr. In period I, all embryos were transferred on day 3 (1032 cycles). In period II, the embryos were transferred on either day 3 or day 5 by determining their replacement date based on the number and quality of 2-day embryos: there were 2701 patients in whom embryos were replaced on day 3 (in the case that the number of zygotes was less than eight and the number of good-quality embryos was less than three) and 1952 patients less than 40 years old in whom embryos were replaced on day 5 (in the case that the number of zygotes was eight or more and/or the number of good-quality embryos was three or more). On the other hand, patients who were 40 years old or more were alloted to day 3 transfer cycles, regardless of the number and quality of the 2-day embryos, due to the possibility of their not producing blastocyst-stage embryos in vitro.

Results: The number of embryos transferred in period II was 2.9 ± 0.6, while that in period I was 3.7 ± 0.5. The multiple pregnancy rate was significantly decreased in period II (30.7%) compared to that (49.6%) in period I, while the pregnancy and implantation rates in period II (36.1 and 16.4%, respectively) were not lower than those (34.9 and 16.1%, respectively) in period I. The rate of triplet or more gestations was significantly minimized in period II (2.3%) compared to that in period I (26.5%).

Conclusions: We propose that determination of the date on which embryos should be transferred based on the number and quality of embryos on day 2 may help to maintain an acceptable pregnancy rate, while minimizing embryo transfer failure and high-order multiple gestations.