Multiple pregnancy after single or multiple embryo transfer performed according to Korean guidelines

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization (IVF)
• Embryo Transfer Guidelines

Background:

• Korean guidelines exist for embryo transfer to optimize outcomes and minimize multiple pregnancies.
• Assessing adherence to these guidelines is crucial for reproductive success.

Purpose of the Study:

• To evaluate compliance with Korean embryo transfer guidelines.
• To identify reasons for non-compliance.
• To analyze multiple pregnancy rates based on specific conditions within compliant cycles.

Main Methods:

• Retrospective analysis of 256 fresh IVF cycles (2012-2014).
• Comparison of actual embryo transfers against guideline recommendations (based on age, transfer day, and conditions).
• Calculation of clinical pregnancy rates (PR) and multiple pregnancy rates (MPR).

Main Results:

• High compliance rate (96.5%) with Korean guidelines.
• Non-compliance in 9 cycles due to poor embryo quality, implantation failure, or hostile endometrium.
• In compliant cycles: PR 31.2%, MPR 27.3% (20 twins, 1 triplet).
• Higher MPR observed with 3 cleavage embryos (women 35-39, favorable conditions) and 2 blastocysts (women ≥40, favorable conditions).

Conclusions:

• High adherence to Korean embryo transfer guidelines was achieved in the study center.
• Multiple pregnancies were more common in cycles with favorable conditions.
• Consideration should be given to reducing embryo transfers below guideline recommendations for high-risk groups to lower MPR.