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Clinical pregnancy and live birth increase significantly with every additional blastocyst up to five and decline after that: an analysis of 16,666 first fresh single-blastocyst transfers from the Society for Assisted Reproductive Technology registry.

Publication ,  Journal Article
Smeltzer, S; Acharya, K; Truong, T; Pieper, C; Muasher, S
Published in: Fertil Steril
November 2019

OBJECTIVE: To study the association between the number of blastocysts available and pregnancy outcomes in first fresh autologous single blastocyst transfer cycles. DESIGN: Retrospective cohort study. SETTING: Not applicable. PATIENT(S): Patients from the Society for Assisted Reproductive Technology reporting fertility clinics (n=16,666). INTERVENTIONS(S): None. MAIN OUTCOME MEASURE(S): Primary outcomes were clinical pregnancy (CP), live birth (LB), and miscarriage rates. Logistic regression was used to investigate the association between the number of blastocysts and each outcome. RESULT(S): When comparing fresh single blastocyst transfer rates, the odds of a positive pregnancy outcome (CP) increased significantly with each additional supernumerary blastocyst up to five and declined by 2% for every additional blastocyst after five. Similarly, the odds of an LB was 17% higher for each additional blastocyst up to five and declined by 2% for every additional blastocyst after five. There was no significant association between blastocyst number and miscarriage rate. CONCLUSION(S): Odds of positive pregnancy outcomes (CP, LB) increased significantly with every additional blastocyst up to five, but declined after that, in first fresh autologous cycles with single-blastocyst transfer. The decline after five may be explained by a detrimental effect on endometrial receptivity in patients with a large number of oocytes or inadequate selection of the best embryo for transfer based on morphology alone.

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Published In

Fertil Steril

DOI

EISSN

1556-5653

Publication Date

November 2019

Volume

112

Issue

5

Start / End Page

866 / 873.e1

Location

United States

Related Subject Headings

  • Societies, Medical
  • Retrospective Studies
  • Reproductive Techniques, Assisted
  • Registries
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Live Birth
  • Humans
  • Female
  • Embryo Transfer
 

Citation

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Chicago
ICMJE
MLA
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Smeltzer, Stephanie, Kelly Acharya, Tracy Truong, Carl Pieper, and Suheil Muasher. “Clinical pregnancy and live birth increase significantly with every additional blastocyst up to five and decline after that: an analysis of 16,666 first fresh single-blastocyst transfers from the Society for Assisted Reproductive Technology registry.Fertil Steril 112, no. 5 (November 2019): 866-873.e1. https://doi.org/10.1016/j.fertnstert.2019.06.030.
Journal cover image

Published In

Fertil Steril

DOI

EISSN

1556-5653

Publication Date

November 2019

Volume

112

Issue

5

Start / End Page

866 / 873.e1

Location

United States

Related Subject Headings

  • Societies, Medical
  • Retrospective Studies
  • Reproductive Techniques, Assisted
  • Registries
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Live Birth
  • Humans
  • Female
  • Embryo Transfer