[Towards a single embryo transfer: predictive value of uterine and embryological parameters in assisted reproduction outcome].
OBJECTIVE
The transfer of a single embryo would avoid obstetrical and neonatal complications due to multiple pregnancies. We studied the clinical value of both uterine and embryological parameters to define precise conditions allowing a single embryo transfer without decreasing pregnancy rates.


METHODS
Endometrial parameters expressed by a uterine score together with biological criteria of 131 in vitro fertilization or intracytoplasmic sperm injection attempts were retrospectively analysed.


RESULTS
Two hundred and sixty-two day-3 embryos were replaced through 131 transfers. Fifty-seven pregnancies were induced and 16 twins were obtained. The clinical pregnancy rate was 35.9% and the embryonic implantation rate 24.0%. After the transfer of two embryos, successful implantation was determined by the occurrence of top-quality embryos and simultaneously by a receptive endometrium. The uterine pulsatility index was significantly decreased for twin compared to singleton pregnancies.


CONCLUSIONS
This study confirms that a uterine score constitutes a powerful tool for evaluating the uterine receptivity. This parameter has to be taken into account as well as the embryonic quality, in order to optimise the success rate. Young patients with at least two top-quality embryos available, a high uterine score and a low pulsatility index, have a high risk of multiple births and are suitable for a single-embryo transfer.
Wittemer
C
C
Centre d'AMP, service de biologie de la reproduction, CMCO-SIHCUS, 19, rue Louis-Pasteur, 67303 Schiltigheim, France. christiane.wittemer@wanadoo.fr
Ohl
J
J
Bettahar-Lebugle
K
K
Rongières
C
C
Gerlinger
P
P
Nisand
I
I
D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology*; D005314:Embryonic and Fetal Development; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008845:Microinjections; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D014427:Twins