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Previous Volume 354:1139-1146 March 16, 2006 Number 11 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Schieve, L. A. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Single-embryo transfer has been recommended to reduce the incidence of multiple gestations when in vitro fertilization is performed in women under 36 years of age. We designed a prospective, randomized, controlled trial to determine whether there were any differences in the rates of pregnancy and delivery between women undergoing transfer of a single cleavage-stage (day 3) embryo and those undergoing transfer of a single blastocyst-stage (day 5) embryo.

Methods We studied 351 infertile women under 36 years of age who were randomly assigned to undergo transfer of either a single cleavage-stage embryo (176 patients) or a single blastocyst-stage embryo (175 patients). Multifollicular ovarian stimulation was performed with a gonadotropin-releasing hormone antagonist and recombinant follicle-stimulating hormone.

Results The study was terminated early after a prespecified interim analysis (which included 50 percent of the planned number of patients) found a higher rate of pregnancy among women undergoing transfer of a single blastocyst-stage embryo (P=0.02). The rate of delivery was also significantly higher in this group than in the group undergoing transfer of a single cleavage-stage embryo (32.0 percent vs. 21.6 percent; relative risk, 1.48; 95 percent confidence interval, 1.04 to 2.11). Two multiple births occurred, both of monozygotic twins, both of which were in the group undergoing transfer of a single cleavage-stage embryo.

Conclusions These findings support the transfer of a single blastocyst-stage (day 5) embryo in infertile women under 36 years of age.

Source Information

From the Centre for Reproductive Medicine, Academisch Ziekenhuis, Vrije Universiteit Brussel, Brussels.

Address reprint requests to Dr. Papanikolaou at the Academisch Ziekenhuis–Vrije Universiteit Brussel, Centre for Reproductive Medicine, Laarbeeklaan 101, Brussels B-1090, Belgium, or at evangelos.papanikolaou{at}vub.ac.be.

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