The effect on pregnancy and multiples of transferring 1–3 embryos in women at least 40 years old
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Purpose "Capsule" is mandatory. Please provide.Single emrbyo transfer (SET) in women ≥40 years old appears to lower the chance of a pregnancy. However, it minimizes the risk of multiple pregnancies even in women of advanced maternal age. Therefore, women 40 years of age or older should be offered (SET).
This study was performed to investigate the multiple pregnancies and live birth rates when 1–3 embryos are transferred at this age in women at least 40 years of age.
A retrospective analysis of data which included 631 women aged 40 to 46 years, who underwent 901 cycles of IVF, from August 2010 to June 2012 was undertaken. These women underwent embryo transfer of 1–3 non-donor fresh embryo(s).
Results suggested that the average pregnancy rate when up to three embryos were transferred was 25 % for women 40 years old, 20 % for women 41 years old, 16 % for women 42 years old, 17 % for women 43 years old, 8 % for women 44 years old, 6 % for women 45 years old, and 0 % for women 46 years old. No live births occurred in women treated after their 44th birthday, and only patients younger than 42 years of age receiving double embryo transfer had a live birth of twins. Live birth rates increased as more embryos were transferred for 40- and 42-year-old subjects (p = 0.01 and 0.05, respectively).
From these results, it was concluded that SET in women ≥40 years old appears to lower the chance of a pregnancy. However, it minimizes the risk of multiple pregnancies even in women of advanced maternal age. Women 40 years of age or older should be offered single-embryo transfer. Further studies are needed to determine risk of multiple pregnancies in women 42 years of age or older when few embryos are transferred. Decisions on the number of embryos to transfer should be on a case by case basis, in discussion with the patient.
KeywordsAssisted reproductive technology Elective single-embryo transfer Multiple pregnancy rates Advanced maternal age
- 1.The ESHRE ART fact sheet. Available at: http://www.eshre.eu/ESHRE/english/guidelines-legal/ART-facttsheet/page.aspx/1061.
- 2.Society for assisted reproductive technology. 2014 SART data. Available at: http://www.cdc.gov/art/reports/index.html.
- 3.Scotland GS, McLernon D, Kurinczuk JJ, McNamee P, Harrild K, Lyall H, et al. Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon. BJOG. 2011;118:1073–83.CrossRefPubMedGoogle Scholar
- 15.Baker VL, Jones CE, Cometti B, Hoehler F, Salle B, Urbancsek J, et al. Factors affecting success rates in two concurrent clinical IVF trials: an examination of potential explanations for the difference in pregnancy rates between the United States and Europe. Fertil Steril. 2010;94:1287–91.CrossRefPubMedGoogle Scholar
- 19.Yang Z, Salem SA, Liu X, Kuang Y, Salem RD, Liu J. Selection of euploid blastocysts for cryopreservation with array comparative genomic hybridization [aCGH] results in increased implantation rates in subsequent frozen and thawed embryo transfer cycles. Mol Cytogenet. 2013:9;6:32.Google Scholar
- 20.Criteria for number of embryos to transfer: a committee opinion. The Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Assisted Reproductive Technology. Fertil Steril. 2013:99:44–6.Google Scholar
- 25.Tan SL, Maconochie N, Doyle P, Campbell S, Balen A, Bekir J, et al. Cumulative conception and live-birth rates after in vitro fertilization with and without the use of long, short, and ultrashort regimens of the gonadotropin releasing hormone agonist buserelin. Am J Obstet Gynecol. 1994;171:513–20.CrossRefPubMedGoogle Scholar