title: Blastocyst culture and transfer: a step toward improved in vitro fertilization outcome.
abstract: OBJECTIVE
  To evaluate the efficacy of blastocyst culture and transfer in human in vitro fertilization (IVF) as compared to day 3 embryo transfer.
  
  
  METHODS
  Prospective randomized trial.
  
  
  METHODS
  Private assisted reproduction unit.
  
  
  METHODS
  A total of 162 IVF patients were included in the day 3 embryo transfer (n = 82) and blastocyst transfer (n = 80) groups.
  
  
  METHODS
  Embryo transfer on day 3 after culture in the standard culture media and blastocyst transfer on day 5 or 6 after culture in the sequential culture media.
  
  
  METHODS
  Implantation and pregnancy rates, multiple gestation rate.
  
  
  RESULTS
  The implantation rate for embryos transferred at the blastocyst stage was significantly higher than that for embryos transferred on day 3 (26% vs. 13%). The viable pregnancy rate was similar in both groups (29% vs. 26%). Significantly fewer embryos were required for transfer at the blastocyst stage compared with day 3 embryo transfer (2.0 +/- 0.1 vs. 3.5 +/- 0.63). The high-order multiple gestation rate was significantly less with the blastocyst transfer than with the day 3 embryo transfer (4% vs. 19%).
  
  
  CONCLUSIONS
  With the use of blastocyst culture, a few embryos can be transferred without decreasing the overall pregnancy rate. This may reduce multiple gestations and improve human IVF outcome.
authors.affiliation: Fertility and Assisted Reproduction Unit, Amman, Jordan. alrabia@joinnet.com.jo
authors.forename: Raja Z
authors.initials: RZ
authors.lastname: Karaki
authors.forename: Sadoon S
authors.initials: SS
authors.lastname: Samarraie
authors.forename: Nagham A
authors.initials: NA
authors.lastname: Younis
authors.forename: Tarek M
authors.initials: TM
authors.lastname: Lahloub
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Ibrahim
mesh_terms: D001755:Blastocyst / Q000166:cytology*; D018929:Cell Culture Techniques / Q000379:methods; D015925:Cryopreservation; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009865:Oocytes / Q000502:physiology; D011247:Pregnancy / Q000706:statistics & numerical data*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D011446:Prospective Studies; D013997:Time Factors