Elective single blastocyst transfer is more suitable for normal responders than for high responders

作     者：WU Ke-liang ZHAO Hai-bin LIU Hui ZHONG Wan-xia YU Guan-ling CHEN Zi-jiang 

作者机构：Center for Reproductive Medicine Provincial Hospital Affiliated to Shandong University National Research Center for Assisted Reproductive Technology and Reproductive Genetics China Key laboratory for Reproductive Endocrinology of Ministry of Education Shandong Provincial Key Laboratory of Reproductive Medicine Jinan Shandong 250021 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2013年第126卷第11期

页      面：2125-2128页

核心收录：

学科分类：081405[工学-防灾减灾工程及防护工程] 1002[医学-临床医学] 0905[农学-畜牧学] 08[工学] 09[农学] 090501[农学-动物遗传育种与繁殖] 0814[工学-土木工程] 

基　　金：Science Research Foundation Item of No-Earnings Health Vocation funded by the grants from the National Basic Research Program of China (973 Program) 

主　　题：embryo transfer elective single blastocyst transfer high responder normal responder 

摘      要：Background Embryo quality and receptivity of the endometrium are two factors that determine the results of in vitro fertilization/intra-cytoplasmic sperm injection-embryo transfer （IVF/ICSI-ET）. There is no consensus of the optimal transfer strategy for normal responders or high responders. The current study aimed to find the optimal transfer strategy for different subgroups of patients. Methods From April 2010 to December 2010, patients who meet the following criteria were included in this study; primary infertility, female age 〈35 years, FSH level on female cycle day 2-3 〈12 mlU/ml, at least six good quality embryos available on day three.The clinical outcomes using different transfer strategies between normal responders and high responders were reviewed and compared. Results For the normal responders, the clinical pregnancy rate of day three double-embryo transfer （DET） was comparable to that of day five elective single blastocyst transfer （eSBT）, 64.04% vs. 60.33% （P〉0.05）. For the high responders, the clinical pregnancy rate of day five eSBT was significantly lower than that of day three DET, 43.35% vs. 57.21% （P〈0.05）. For the high responders, the rates of clinical pregnancy and implantation in frozen-thawed embryo transfer （FET） cycles were notably higher than in eSBT cycles （64.56% vs. 43.35% and 62.11% vs. 43.35% respectively） （P〈0.05）. Conclusions For normal responders, eSBT might be an applicabte strategy to reduce multiple pregnancy rates while maintaining acceptable overall pregnancy rates. And in order to reduce multiple pregnancies and increase the chance of pregnancy of high responders, FET may be a preferable strategy.