Author/Editor     Vlaisavljević, Veljko; Hojnik, Nina; Kovačič, Borut; Reljič, Milan; Gavrić-Lovrec, Vida; Kovač, Vilma; Mlakar, Lea
Title     Implementation of blastocyst transfer in the routine clinical practice of assisted reproductive techniques
Type     članek
Vol. and No.     , št. 1
Publication year     2014
Volume     str. 83-90
Language     eng
Abstract     Background: All patients who entered our assisted reproductive technology (ART) program during last 7 years were analyzed in order to compare the outcome of in vitro fertilization (IVF) cycles after early cleavage stage embryo transfers and blastocyst transfers. Methods: All patients with successful oocyte pick up (OPU) after controlled ovarian hiperstimulation in the period from 2002 to 2008 were included in this retrospective analysis. The cycles were stratified with respect to the number of aspirated oocytes as follows: poor responders in whom only a single oocyte was aspirated, low responders with 2 to 4 oocytes, and good responders with more than 4 oocytes retrieved. Pregnancy, delivery and multiple delivery rates were calculated and compared between the cycles with day 3 and cycles with day 5 embryo transfers. Results: Among 6098 included patients, 292 (4.8 %) were poor, 1450 (23.8 %) low and 4356 (71.4 %) good responders. Total fertilization failure was observed in 5.7 % (350/6098) of all cycles. Among the cycles with fertilization, embryo transfer on day 3 was planned in 1940 (33.9 %) cycles and blastocyst transfer on day 5 in 3788 (66.1 %) cycles. Transfer was cancelled in 6.8 % (394/5748) of cycles, more frequently after embryo culturing in vitro for 5 than for 3 days (7.8 % vs. 6.1 %). However, more women delivered after blastocyst transfer compared to early stage embryo transfers in low (9.5 % vs. 6.1 %), poor (23.7 % vs. 15.2 %) and normal (39.9% vs. 17.3 %) responders. Multiple delivery rate was also higher after blastocyst rather then after early embryo transfers in low (24.3 % vs. 13.3 %) and normal (29.4 % vs. 24.6 %) responders. Conclusions: The transfer of blastocyst stage embryos increases the success rate of ART procedures in all patients. To avoid multiple pregnancies, single blastocyst transfer is recommended.
Descriptors     Reproductive Techniques, Assisted
Reproduktivne tehnike, asistirane
Blastocyst
Blastocista
Embryo Transfer
Zarodek, prenos
Pregnancy
Nosečnost
Delivery, Obstetric
Porod
Treatment Outcome
Izid zdravljenja