title: Programmatic implementation of blastocyst transfer in a university-based in vitro fertilization clinic: maximizing pregnancy rates and minimizing triplet rates.
abstract: To assess whether the use of extended embryo culture can reduce the incidence of high-order multiple gestations, a retrospective analysis of 7,418 fresh ETs performed in a university-based IVF clinic from 1997-2003 was conducted, comparing program results before and after institution of a protocol to select patients for extended culture of in vitro fertilized embryos. The incidence of triplet pregnancies was significantly reduced in patients at highest risk for high-order multiple gestations, i.e., those at <35 years of age (16.8% versus 6.8%), those at 35-37 years of age (13.0% versus 5.6%), and recipients of donated oocytes (11.2% versus 4.5%).
authors.affiliation: New York University Fertility Center, New York University School of Medicine, New York, New York 10016, USA. jamie.grifo@med.nyu.edu
authors.forename: James A
authors.initials: JA
authors.lastname: Grifo
authors.forename: Eric
authors.initials: E
authors.lastname: Flisser
authors.forename: Alexis
authors.initials: A
authors.lastname: Adler
authors.forename: Caroline
authors.initials: C
authors.lastname: McCaffrey
authors.forename: Lewis C
authors.initials: LC
authors.lastname: Krey
authors.forename: Frederick
authors.initials: F
authors.lastname: Licciardi
authors.forename: Nicole
authors.initials: N
authors.lastname: Noyes
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kump
authors.forename: Alan S
authors.initials: AS
authors.lastname: Berkeley
mesh_terms: D000328:Adult; D046149:Embryo Culture Techniques / Q000379:methods*; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D014310:Triplets; D014427:Twins