title: Pregnancy and twinning rates using a tailored embryo transfer policy.
abstract: A tailored embryo transfer policy based on the prognostic profile of the couple was prospectively evaluated. Single-embryo transfer (SET) was performed, followed by double-embryo transfer (DET) in frozen-thawed embryo transfer cycles in women with a good prognosis (<35 years, first cycle, ⩾1 top-quality embryo). DET was performed in both fresh and frozen cycles in women with an intermediate prognosis (<35 years, first cycle and no top-quality embryo available, or <35 years and ⩾1 failed cycles, or 35-38 years). Triple-embryo transfer (TET) in both fresh and frozen cycles was performed in women with a poor prognosis (⩾39 years). The cumulative ongoing pregnancy rate in the cycles of women with a good prognosis was 43% with a multiple pregnancy rate of 2%, in the cycles of women with an intermediate prognosis 27% and 23% and in the cycles of women with a poor prognosis 18% and 13%, respectively. These findings can be used to guide current practice: i.e. performing SET in women with a good prognosis and TET in women with a poor prognosis. The embryo transfer strategy in women with an intermediate prognosis requires further improvement, possibly by refining the prognosis according to the ovarian response after ovarian stimulation.
authors: Center for Reproductive Medicine, Women's and Children's Hospital, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. l.l.vanloendersloot@amc.uva.nl
authors: Laura
authors: L
authors: van Loendersloot
authors: Madelon
authors: M
authors: van Wely
authors: Mariëtte
authors: M
authors: Goddijn
authors: Sjoerd
authors: S
authors: Repping
authors: Patrick
authors: P
authors: Bossuyt
authors: Fulco
authors: F
authors: van der Veen
mesh_terms: D000328:Adult; D000367:Age Factors; D001755:Blastocyst / Q000502:physiology; D015331:Cohort Studies; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D006291:Health Policy; D006801:Humans; D009426:Netherlands; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D014427:Twins / Q000706:statistics & numerical data*