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Clinical implications of developments in in vitro fertilisation
British Medical Journal (Clinical Research Ed.)
|October 13, 1984
Summary
Transferring multiple embryos in in vitro fertilization (IVF) significantly increases pregnancy rates, with three embryos yielding the best results. Despite a slight rise in multiple pregnancies, this approach offers a better chance of conception compared to single embryo transfer.
Area of Science:
- Reproductive Medicine
- In Vitro Fertilisation (IVF)
- Embryology
Background:
- Infertile couples undergoing IVF face complex decisions regarding oocyte collection, fertilization, embryo transfer, and cryopreservation.
- Optimizing IVF protocols is crucial for improving conception rates and managing patient outcomes.
Purpose of the Study:
- To analyze the impact of the number of embryos transferred on pregnancy rates in IVF.
- To evaluate the outcomes of frozen-thawed embryo transfers and donor oocyte embryo transfers.
- To provide insights into the utilization of oocytes and embryos in IVF treatment cycles.
Main Methods:
- Retrospective analysis of 1530 IVF treatment cycles from February 1979 to December 1983 involving 831 infertile couples.
- Comparison of pregnancy rates based on the number of embryos transferred (one, two, or three).
- Assessment of outcomes for frozen-thawed and donor oocyte embryo transfers.
Main Results:
- Pregnancy rates increased significantly with the number of embryos transferred: 7.4% for one, 21.1% for two, and 28.1% for three embryos.
- While multiple pregnancies increased with more embryos transferred, the overall risk was considered acceptable compared to single embryo transfer outcomes.
- Frozen-thawed embryo transfers resulted in a 17% pregnancy rate, and donor oocyte embryo transfers yielded a 12% pregnancy rate, with some abortions.
Conclusions:
- Transferring multiple embryos, particularly two or three, is more effective in achieving pregnancy than transferring a single embryo.
- Discarding oocytes based on perceived abnormalities is not recommended, as their developmental potential cannot be accurately predicted and may reduce conception chances.
- It is suggested that all harvested oocytes should be inseminated, with embryo utilization decisions made after observing their development.