title: Prevention of multiple pregnancies after IVF in women 38 and older: a randomized study.
abstract: The objective of this study was to answer the question of whether a double instead of triple embryo transfer strategy in patients over 38 years would substantially reduce the number of multiple pregnancies while maintaining the chance of a term live birth at an acceptable level. A randomized controlled two-centre trial was performed. Forty-five patients, 38 years or older, were randomized. Double embryo transfer over a maximum of four cycles (DET group) or triple embryo transfer over a maximum of three cycles (TET group) was performed. The cumulative term live birth rate was 47.3% after four cycles in the DET group and 40.5% after three cycles in the TET group. The difference between the DET and the TET group was 6.8% in favour of the DET group (95% CI -25 to 38). The multiple pregnancy rates in the DET and TET group were 0% (95% CI 0 to 24) and 30% (95% CI 7 to 65) respectively (P = 0.05). In the DET patients, the mean number of treatment cycles was 2.9 compared with 2.1 in the TET group (P = 0.01). In women of 38 years and older, double embryo transfer after IVF may result in similar cumulative term live birth rates compared with triple embryo transfer, provided that a higher number of treatment cycles is accepted.
authors.affiliation: Department of Reproductive Medicine, University Medical Centre, Utrecht, The Netherlands.
authors.forename: E M E W
authors.initials: EM
authors.lastname: Heijnen
authors.forename: E R
authors.initials: ER
authors.lastname: Klinkert
authors.forename: A P E
authors.initials: AP
authors.lastname: Schmoutziguer
authors.forename: M J C
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: E R
authors.initials: ER
authors.lastname: te Velde
authors.forename: F J M
authors.initials: FJ
authors.lastname: Broekmans
mesh_terms: D000328:Adult; D015925:Cryopreservation; D004624:Embryo Transfer / Q000009:adverse effects; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple