title: Do donor oocyte cycles comply with ASRM/SART embryo transfer guidelines? An analysis of 13,393 donor cycles from the SART registry.
abstract: To analyze donor oocyte cycles in the Society for Assisted Reproductive Technology (SART) registry to determine: 1) how many cycles complied with the 2009 American Society for Reproductive Medicine/SART embryo transfer guidelines; and 2) cycle outcomes according to the number of embryos transferred. For donor oocyte IVF with donor age <35 years, the consideration of single-embryo transfer was strongly recommended.
  
  
  
  Retrospective cohort study of United States national registry information.
  
  
  
  Not applicable.
  
  
  
  A total of 13,393 donor-recipient cycles from 2011 to 2012.
  
  
  
  Embryos transferred in donor IVF cycles.
  
  
  
  Percentage of compliant cycles, multiple pregnancy rate.
  
  
  
  There were 3,157 donor cleavage-stage transfers and 10,236 donor blastocyst transfers. In the cleavage-stage cycles, 88% met compliance criteria. The multiple pregnancy rate (MPR) was significantly higher in the noncompliant cycles. In a subanalysis of compliant cleavage-stage cycles, 91% transferred two embryos and only 9% single embryos. In those patients transferring two embryos, the MPR was significantly higher (33% vs. 1%). In blastocyst transfers, only 28% of the cycles met compliance criteria. The MPR was significantly higher in the noncompliant blastocyst cohort at 53% (compared with 2% in compliant cycles).
  
  
  
  The majority of donor cleavage-stage transfers are compliant with current guidelines, but the transfer of two embryos results in a significantly higher MPR compared with single-embryo transfer. The majority of donor blastocyst cycles are noncompliant, which appears to be driving an unacceptably high MPR in these cycles.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University, Durham, North Carolina.
authors.forename: Kelly S
authors.initials: KS
authors.lastname: Acharya
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University, Durham, North Carolina.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Keyhan
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina.
authors.forename: Chaitanya R
authors.initials: CR
authors.lastname: Acharya
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University, Durham, North Carolina.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Yeh
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University, Durham, North Carolina.
authors.forename: Meredith P
authors.initials: MP
authors.lastname: Provost
authors.affiliation: University Hospitals Fertility Center, Beachwood, Ohio.
authors.forename: James M
authors.initials: JM
authors.lastname: Goldfarb
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University, Durham, North Carolina. Electronic address: muashersj@gmail.com.
authors.forename: Suheil J
authors.initials: SJ
authors.lastname: Muasher
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D004624:Embryo Transfer / Q000009:adverse effects / Q000592:standards*; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro / Q000009:adverse effects / Q000592:standards*; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008423:Maternal Age; D018587:Oocyte Donation / Q000009:adverse effects / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D012042:Registries; D012189:Retrospective Studies; D056826:Single Embryo Transfer / Q000592:standards; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: IVF; In vitro fertilization; blastocysts; donor; embryo transfer; multiple pregnancy; oocytes