Spontaneous embryonic loss rates in twin and singleton pregnancies after transfer of top- versus intermediate-quality embryos.
OBJECTIVE
To determine whether embryo quality is associated with early spontaneous loss rates in twin and singleton pregnancies after IVF/intracytoplasmic sperm injection (ICSI).


METHODS
Retrospective, single center analysis.


METHODS
The Center of Reproductive Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.


METHODS
Women undergoing IVF/ICSI and two- or three-embryo transfer of intermediate- and top-quality embryos.


METHODS
First-trimester sonography at 6 to 7 weeks to determine number of embryos with positive heartbeat. Number of embryos lost was calculated from a second-trimester sonogram.


METHODS
Rates of total pregnancy loss, as related to embryo quality, initial number of embryos, maternal age <35 or > or =35 years, and IVF procedure.


RESULTS
A total of 94 losses (23.1% of 407 pregnancies) were counted, with similar proportions in pregnancies after transfer of intermediate- or top-quality embryos. Neither the mode of IVF procedure nor the number of transferred embryos affected the loss rate. In contrast, the loss rate was significantly higher in older mothers after transfer of intermediate-quality embryos (odds ratio [OR 2.4], 95% confidence interval [CI] 1.1-5.5). Losses among singletons were significantly higher compared with losses among twins (OR 2.5, 95% CI 1.1-6.0), but this was observed in top-quality embryos only.


CONCLUSIONS
Top-quality but not intermediate-quality ETs are associated with lower early spontaneous loss rates among twin pregnancies after IVF/ICSI.
La Sala
Giovanni B
GB
Department of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
Nicoli
Alessia
A
Villani
Maria Teresa
MT
Gallinelli
Andrea
A
Nucera
Giuseppe
G
Blickstein
Isaac
I
D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D001755:Blastocyst; D004624:Embryo Transfer / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011261:Pregnancy Trimester, First; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000592:standards* / Q000706:statistics & numerical data; D014427:Twins