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In Vitro Fertilization

In Vitro Fertilization

In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...

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Updated: Mar 12, 2026

Co-transplantation of Human Ovarian Tissue with Engineered Endothelial Cells: A Cell-based Strategy Combining Accelerated Perfusion with Direct Paracrine Delivery

Co-transplantation of Human Ovarian Tissue with Engineered Endothelial Cells: A Cell-based Strategy Combining Accelerated Perfusion with Direct Paracrine Delivery

Published on: May 16, 2018

Optimal embryo transfer strategy in poor response may include freeze-all.

Murat Berkkanoglu¹, Kevin Coetzee², Hasan Bulut²

¹Antalya IVF, Halide Edip Cd. No: 7, Kanal Mh, Antalya, 07080, Turkey. mberkkan@hotmail.com.

Journal of Assisted Reproduction and Genetics

|November 11, 2016

Summary

For women undergoing intracytoplasmic sperm injection (ICSI) with few oocytes, blastocyst embryo transfer (ET) resulted in higher pregnancy and live birth rates compared to cleavage stage ET. This suggests blastocyst transfer may benefit poor responders.

Keywords:

Blastocyst culture Diminished ovarian reserve Freeze-all Poor response

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Last Updated: Mar 12, 2026

Co-transplantation of Human Ovarian Tissue with Engineered Endothelial Cells: A Cell-based Strategy Combining Accelerated Perfusion with Direct Paracrine Delivery

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Published on: May 16, 2018

OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery

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Published on: May 9, 2021

Fertility Preservation in Patients with Severe Ovarian Dysfunction

Fertility Preservation in Patients with Severe Ovarian Dysfunction

Published on: March 25, 2021

Area of Science:

Reproductive Medicine
Embryology
In Vitro Fertilization

Background:

Intracytoplasmic sperm injection (ICSI) is a key assisted reproductive technology (ART).
Embryo transfer (ET) strategy significantly impacts ART outcomes.
Optimal ET strategies for poor responders (defined by oocyte yield) are debated.

Purpose of the Study:

To determine the most effective embryo transfer strategy for ICSI cycles with a limited number of retrieved oocytes (≤4).
To compare outcomes of cleavage stage versus blastocyst stage embryo transfer in poor responders undergoing ICSI.
To evaluate the impact of blastocyst cryopreservation and warming on pregnancy outcomes.

Main Methods:

Retrospective cohort study of 2263 women undergoing ICSI.
Group 1 (n=879): ≤4 oocytes retrieved; Group 2 (n=1384): 10-15 oocytes retrieved.
Subgroups within each group underwent either cleavage stage ET (Group A, C) or blastocyst ET (Group B, D), with blastocysts vitrified using the Cryotop method.

Main Results:

In women with ≤4 oocytes, blastocyst ET (Group B) showed significantly higher clinical pregnancy, implantation, and live birth rates per ET compared to cleavage ET (Group A).
In women with 10-15 oocytes, blastocyst ET (Group D) also demonstrated superior clinical pregnancy, implantation, and live birth rates per ET.
Cycle cancellation rates were lower with cleavage stage ET in both groups, but blastocyst ET yielded better live birth rates per ET.

Conclusions:

Blastocyst embryo transfer, coupled with cryopreservation, offers improved pregnancy outcomes, challenging the traditional approach of reserving this strategy for high responders.
The findings suggest that poor responders undergoing ICSI may benefit from a Day 5 embryo transfer strategy.
Further research may explore optimizing blastocyst culture and cryopreservation for all patient groups.