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Transfer of only 2 embryos
Title:Implantation rates after in vitro fertilization and transfer of a maximum of two embryos that have undergone three to five days of culture
Author: G. Huisman, et al.
Address: Roterdam, the Netherlands
Source:Fertility and sterility 73: 117-122 (January) 2000
Summary: This prospective study was conducted to evaluate implantation and pregnancy rates in patients undergoing IVF after the transfer of a maximum of 2 embryos that had been cultured for 3-5 days. Participants were 1,787 couples who underwent their first IVF cycle between 01/95-12/97. Overall implantation and pregnancy rates were not significantly different with different culture periods. 41% of all available embryos developed into blastocysts on day 5. The transfer of at least one good-quality blastocyst could be performed in 62% of patients. Blastocysts had an implantation rate of 26% per embryo, and the implantation rate of eight-cell embryos on day 3 was 18%. The transfer of embryos after 5 days as opposed to 3 days of embryo culture did not change the overall implantation and pregnancy rates. Researchers concluded that the implantation potential of embryos available for transfer can be assessed better after an extended culture period. Further, 5 days of culture allows the transfer of a reduced number of embryos without decreasing overall pregnancy rates.
Comment: Most in the US seem to equate the transfer of two embryos with the transfer of 2 good embryos. Nothing could be further from the truth. It is interesting that the authors fail to show an improvement with extended blastocyst culture. Transfer of two embryos makes a lot of sense on many grounds.