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Elective single-embryo transfer improves cumulative pregnancy outcome in young patients but not in women of advanced reproductive age

  • Assisted Reproduction Technologies
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Abstract

Purpose

The purpose of the present study is to assess the significance of elective single-embryo transfer (eSET) in older women.

Methods

The outcomes of assisted reproductive technology between 2001 and 2013 at single institution were retrospectively evaluated. Cumulative live birth rates (CLBRs) in one oocyte retrieval cycle were compared between those who underwent eSET and multiple embryo transfer (MET) in fresh cycles.

Results

The outcomes of 429 eSET cycles and 965 MET cycles were compared. CLBRs in eSET were higher than those of MET in women under 37 and were comparable in women aged 37 and over. The analysis of the outcomes separately in three age subgroups showed a significantly higher CLBR in young eSET (aged under 37) than that in young MET and similar CLBR between older (aged 37–40 and over 40) eSET and MET. Multiple birth rates were lower in eSET in all age groups. Multivariate logistic regression analyses showed that, in women aged under 37, number of frozen embryos, presence of good-quality embryos, and eSET were significantly related to cumulative live birth. In women aged between 37 and 40, age and number of frozen embryos were significantly related, while eSET was not.

Conclusions

eSET in women under 37 resulted in increased CLBR compared with MET. In women aged between 37 and 40, CLBR in eSET group was similar with that in MET group. In both age groups, eSET reduced multiple birth rates. The significance of eSET in older women is limited presently, and further research on the strategy to improve cumulative outcomes is necessary.

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References

  1. Pinborg A. IVF/ICSI twin pregnancies: risks and prevention. Hum Reprod Update. 2005;11:575–93.

    Article  PubMed  Google Scholar 

  2. Gerris J, De Neubourg D, Mangelschots K, Van Royen E, Van de Meerssche M, Valkenburg M. Prevention of twin pregnancy after in-vitro fertilization or intracytoplasmic sperm injection based on strict embryo criteria: a prospective randomized clinical trial. Hum Reprod. 1999;14:2581–7.

    Article  CAS  PubMed  Google Scholar 

  3. Strandell A, Bergh C, Lundin K. Selection of patients suitable for one-embryo transfer may reduce the rate of multiple births by half without impairment of overall birth rates. Hum Reprod. 2000;15:2520–5.

    Article  CAS  PubMed  Google Scholar 

  4. Fauque P, Jouannet P, Davy C, Guibert J, Viallon V, Epelboin S, et al. Cumulative results including obstetrical and neonatal outcome of fresh and frozen-thawed cycles in elective single versus double fresh embryo transfers. Fertil Steril. 2010;94:927–35.

    Article  PubMed  Google Scholar 

  5. McLernon DJ, Harrild K, Bergh C, Davies MJ, de Neubourg D, Dumoulin JC, et al. Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials. BMJ. 2010;341:c6945.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Veleva Z, Vilska S, Hyden-Granskog C, Tiitinen A, Tapanainen JS, Martikainen H. Elective single embryo transfer in women aged 36–39 years. Hum Reprod. 2006;21:2098–102.

    Article  PubMed  Google Scholar 

  7. Niinimaki M, Suikkari AM, Makinen S, Soderstrom-Anttila V, Martikainen H. Elective single-embryo transfer in women aged 40–44 years. Hum Reprod. 2013;28:331–5.

    Article  CAS  PubMed  Google Scholar 

  8. Min JK, Hughes E, Young D, Gysler M, Hemmings R, Cheung AP, et al. Elective single embryo transfer following in vitro fertilization. J Obstet Gynaecol Can. 2010;32:363–77.

    PubMed  Google Scholar 

  9. Bianco A, Stone J, Lynch L, Lapinski R, Berkowitz G, Berkowitz RL. Pregnancy outcome at age 40 and older. Obstet Gynecol. 1996;87:917–22.

    Article  CAS  PubMed  Google Scholar 

  10. Veeck LL. An atlas of human gamates and conceptuses: an illustrated reference for assisted reproductive technology. New York: London, Parthenon; 1999.

    Book  Google Scholar 

  11. Bourgain C, Devroey P. The endometrium in stimulated cycles for IVF. Hum Reprod Update. 2003;9:515–22.

    Article  PubMed  Google Scholar 

  12. Roque M, Valle M, Guimaraes F, Sampaio M, Geber S. Freeze-all policy: fresh vs. frozen-thawed embryo transfer. Fertil Steril. 2015;103:1190–3.

    Article  PubMed  Google Scholar 

  13. Roque M. Freeze-all policy: is it time for that? J Assist Reprod Genet. 2015;32:171–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Sanraku Hospital, 2-5 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8326, Japan

    Akihisa Fujimoto

  2. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Akihisa Fujimoto, Kaoru Morishima, Miyuki Harada, Tetsuya Hirata, Yutaka Osuga & Tomoyuki Fujii

Authors
  1. Akihisa Fujimoto
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  2. Kaoru Morishima
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  3. Miyuki Harada
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  4. Tetsuya Hirata
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  5. Yutaka Osuga
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  6. Tomoyuki Fujii
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Corresponding author

Correspondence to Akihisa Fujimoto.

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Funding

This study is not supported by any funding.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board of our institution.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Capsule

Elective SET in women aged 37 and over reduced multiple pregnancy rate but did not improve cumulative live birth rate.

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Fujimoto, A., Morishima, K., Harada, M. et al. Elective single-embryo transfer improves cumulative pregnancy outcome in young patients but not in women of advanced reproductive age. J Assist Reprod Genet 32, 1773–1779 (2015). https://doi.org/10.1007/s10815-015-0598-8

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  • DOI: https://doi.org/10.1007/s10815-015-0598-8

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