Outcomes of elective cryopreserved single or double embryo transfers following failure to conceive after fresh single embryo transfer.
The main adverse effect of IVF is the high multiple pregnancy rate resulting from the transfer of two or more embryos. The objective was to evaluate pregnancy rates in infertile women with a good prognosis who failed to conceive in a fresh elective single embryo transfer (eSET) and had a second cycle with elective double vitrified-warmed embryo transfer (eDFET) compared with elective single vitrified-warmed embryo transfer (eSFET). A total of 142 intracytoplasmic sperm injection cycles using a conventional protocol were evaluated. Good-prognosis patients underwent eSET in a fresh cycle, and those who failed to conceive underwent a second vitrified-warmed embryo transfer: eDFET (n = 102) or eSFET (n = 40). Embryos were transferred and vitrified on day 5 of development. Patients who received eDFET had fewer implantations (30.9%) than eSFET (52.5%; P = 0.004); pregnancy rates were similar (eDFET: 35.3%, eSFET: 42.5%). Patients with the eSFET had one monozygotic twin (5.9%), and 22.2% of eDFET patients had multiple pregnancies. Patients with a good prognosis who failed to conceive in the first fresh eSET did not have an advantage when receiving eDFET in the second cycle, as pregnancy rates were similar; 22.2% of patients in the eDFET group had multiple pregnancies.
Centro de Reprodução Humana, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil. Electronic address: pedro@monteleone.med.br.
Pedro Augusto Araújo
PA
Monteleone
Centro de Reprodução Humana, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil.
R J
RJ
Mirisola
Centro de Reprodução Humana, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil.
S P
SP
Gonçalves
Centro de Reprodução Humana, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil.
Edmund C
EC
Baracat
Centro de Reprodução Humana, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil.
Paulo C
PC
Serafini
D000328:Adult; D015925:Cryopreservation / Q000379:methods*; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008423:Maternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies; D056826:Single Embryo Transfer / Q000379:methods*; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014430:Twins, Monozygotic; D058989:Vitrification
Double embryo transfer; IVF; Infertility; Multiple pregnancies; Single embryo transfer