Blastocyst-stage transfer of poor-quality cleavage-stage embryos results in higher implantation rates.
OBJECTIVE
To determine the feasibility and success of blastocyst-stage embryo transfers in patients having only fair and poor quality cleavage-stage embryos on day 3.


METHODS
Prospective case study with historic controls.


METHODS
Tertiary care private hospital IVF center.


METHODS
A total of 158 day 5 embryo transfer cycles in patients with grade 3 and grade 4 cleavage-stage embryos. Control group consisted of 162 day 3 transfer cycles performed with embryos of similar quality.


METHODS
In vitro culture of embryos up to the blastocyst stage.


METHODS
The percentage of cycles that culminated in the transfer of at least one blastocyst and implantation and pregnancy rate related to the day of transfer.


RESULTS
In the day 3 transfer group, a mean of 5.2 embryos were replaced per patient. This was significantly more than the mean of 2.4 embryos that could be replaced on day 5 (P <.001). The clinical pregnancy rate per embryo transfer was 27.2% and 33.5% in the two groups, respectively (P >.05). The implantation rate per embryo was significantly higher in the day 5 transfer group (15% vs. 5.9%). The multiple pregnancy and abortion rates were similar between the groups.


CONCLUSIONS
Transfer of fair and poor quality embryos at the blastocyst stage is feasible and is associated with higher implantation rates as compared to transfer of similar quality embryos on day 3.
Balaban
B
B
Assisted Reproduction Unit, American Hospital of Istanbul, Turkey.
Urman
B
B
Alatas
C
C
Mercan
R
R
Aksoy
S
S
Isiklar
A
A
D000022:Abortion, Spontaneous / Q000453:epidemiology; D001755:Blastocyst; D002970:Cleavage Stage, Ovum; D046508:Culture Techniques; D010064:Embryo Implantation; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011272:Pregnancy, Multiple