title: The impact of the embryo quality on the risk of multiple pregnancies.
abstract: The aim of the present study was to determine the chance of pregnancy and the risk of multiple pregnancies taking into account the number and quality of transferred embryos in patients >36 years old or ≤36 years old. For this study, 1497 patients undergoing intra-cytoplasmic sperm injection (ICSI) cycles in a private assisted reproduction centre were split into groups according to the number and quality of the transferred embryos on the third or fifth day of development. The pregnancy rate and multiple pregnancy rate were compared between the embryo quality groups in patients <36 years old or ≥36 years old. In patients <36 years old, for the day 3 embryo transfer, no significant difference was noted in the pregnancy rate when the groups were compared. However the multiple pregnancy rate was increased by the transfer of an extra low-quality embryo (17.1 versus 28.2%, P = 0.020). For day 5 embryo transfer, the transfer of an extra blastocyst significantly increased the pregnancy rate (36.0 versus 42.4%, P < 0.001) and the multiple pregnancy rate (4.4 versus 16.9%, P < 0.001). In older patients, no significant difference was noted in the pregnancy rate when the groups were compared. However, when an extra low-quality embryo was transferred, a significantly increased rate of multiple pregnancies was observed for day 3 (18.2 versus 26.4%, P = 0.049) and day 5 embryo transfers (5.2 versus 16.1%, P < 0.001). In conclusion, the transfer of an extra low-quality embryo may increase the risk of a multiple pregnancy. In younger patients, the transfer of an extra low-quality blastocyst may also increase the chance of pregnancy.
authors: Fertility-Centro de Fertilização Assistida,4545 Av. Brigadeiro Luis,São Paulo 01401-002,SP,Brazil.
authors: Daniela Paes de Almeida Ferreira
authors: DP
authors: Braga
authors: Fertility-Centro de Fertilização Assistida,4545 Av. Brigadeiro Luis,São Paulo 01401-002,SP,Brazil.
authors: Amanda S
authors: AS
authors: Setti
authors: Fertility-Centro de Fertilização Assistida,4545 Av. Brigadeiro Luis,São Paulo 01401-002,SP,Brazil.
authors: Rita de Cássia S
authors: Rde C
authors: Figueira
authors: Fertility-Centro de Fertilização Assistida,4545 Av. Brigadeiro Luis,São Paulo 01401-002,SP,Brazil.
authors: Assumpto
authors: A
authors: Iaconelli
authors: Fertility-Centro de Fertilização Assistida,4545 Av. Brigadeiro Luis Antônio,São Paulo 01401-002,SP,Brazil.
authors: Edson
authors: E
authors: Borges
mesh_terms: D000328:Adult; D000367:Age Factors; D001755:Blastocyst / Q000166:cytology / Q000502:physiology; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
keywords: Assisted reproduction; Embryo quality; Embryo transfer; Multiple pregnancy