Impact Of Numbers Of Embryos And Prime Embryos For Transfer On Pregnancy Outcome

Assisted reproductive technology (ART) is the most effective way to treat infertility, and in vitro fertilization-embryo transfer (IVF) is the most representative one. IVF has been developed rapidly in recent30years and are commonly used for couples with various infertilities. With the widely use of IVF and intracytoplasmic sperm injection (ICSI), however, pregnancy complication after IVF including multiple pregnancy (MP) and ectopic pregnancy (EP) has occurred more frequent. How to improve the clinical pregnancy rate (CPR) and prevent MP and EP in the meanwhile is the most important issues at present.ObjectivesWe will explore and analyzed the impact of numbers of embryos and prime embryos to transfer in different age on pregnancy outcome for IVF-ET cycles. Within three groups <35years,35～37years and≥38years, we will compare the single pregnancy rates, multiple pregnancy rates and ectopic pregnancy rates with different numbers of embryos and prime embryos to transfer. We expect the results can be used to instruct our clinic work for patients in different age so as to avoid pregnancy complication following ART and to improve the consequent outcome.Methods4190fresh cycles from infertile patients who underwent IVF-ET and ICSI were retrospectively analyzed, from the Center for Reproductive Medicine of Tianjin Central Hospital of Obstetrics and Gynecology from January2011to September2013. Inclusion criteria:(1) Autologous sperm were used.(2) Fresh cycles of IVF or ICSI were included. The fresh cycles of IVF accorded to routine operation, and72hours after oocyte retrieval was for transplantation. Numbers of transferred embryos was no more than two when age<35years old,≥35years of age transplanted no more than3. Tube graft transplanted from the palace of the end of the depth was1.5cm.14days after transplantation, human chronic gonadotropin (hCG) was checked for blood pregnancy (BP), and four weeks after transplantation, pregnancy capsule with intravaginal ultrasound for clinical pregnancy (CP). The patients were divided into three groups:<35years,35～37years and≥38years. Select the single pregnancy rates, multiple pregnancy rates and ectopic pregnancy rates with different numbers of transferred embryos and prime embryos to compare within three groups, and statistical analysis.Results(1)In4190IVF/ICSI cycles, total1725clinical pregnancies had been achieved, and the CPR was41.17%. Among these clinical pregnancies, the single pregnancies (SP) were1244, the relevant rate was72.12%, the multiple pregnancies (MP) were393, the rate was22.78%, and the ectopic pregnancies (EP) were88, the rate was5.10%.(2)In<35age group, no statistically significant difference was found in clinical pregnancy rate whether transfer one or two embryos/prime embryos, and the multiple pregnancy rate in patients who transfer two prime embryos were higher than those who transfer ones.(3)In35-37age group, no statistically significant difference was found in clinical pregnancy rate whether transfer two or three embryos, and obviously higher than those who transfer one embryo. The multiple pregnancy rate and ectopic pregnancy rate in patients who transfer three prime embryos were obviously higher.(4)In≥38age group, the clinical pregnancy rate was significantly lower than group1and group2, and the multiple pregnancy rate and ectopic pregnancy rate in patients who transfer three prime embryos were higher than those transfer one or two prime embryos.ConclusionsOne prime embryo for transfer is advised for the patients younger than35years, and two prime embryos or two embryos for the patients between35～37years. For the patients aged38or older, it should carefully select three prime embryos to transfer to reduce the risk of multiple pregnancy and ectopic pregnancy.