In vitro fertilization with single euploid blastocyst transfer: a randomized controlled trial

Area of Science:

• Reproductive Medicine
• Genetics
• In Vitro Fertilization

Background:

• Infertility affects numerous couples, necessitating advanced reproductive technologies.
• Assisted reproductive technologies, including in vitro fertilization (IVF), aim to improve pregnancy outcomes.
• Optimizing embryo selection and transfer strategies is crucial for maximizing success rates and minimizing risks.

Purpose of the Study:

• To compare the ongoing pregnancy rate of single euploid blastocyst transfer following comprehensive chromosome screening (CCS) with double untested blastocyst transfer.
• To evaluate the impact of these strategies on the incidence of multiple gestations.

Main Methods:

• A randomized, noninferiority trial was conducted at an academic reproductive medicine center.
• Infertile women (n=205) under 43 with adequate ovarian reserve were enrolled.
• Participants were randomized to either single euploid blastocyst transfer after CCS or double untested blastocyst transfer.

Main Results:

• The ongoing pregnancy rate per randomized patient was comparable between the single euploid blastocyst transfer group (60.7%) and the double untested blastocyst transfer group (65.1%).
• The risk of multiple gestation was substantially reduced in the single euploid blastocyst transfer group (0%) compared to the double untested blastocyst transfer group (53.4%).
• Patients undergoing single euploid blastocyst transfer had a higher likelihood of singleton pregnancies.

Conclusions:

• Single euploid blastocyst transfer following CCS is a viable strategy for achieving ongoing pregnancy rates equivalent to double untested blastocyst transfer in women aged 42 or younger.
• This approach significantly decreases the risk of multiple gestations, leading to a higher probability of singleton pregnancies.