Author/Authors :
Ashrafi، Mahnaz نويسنده , , Madani، Tahereh نويسنده , , Movahedi، Mina نويسنده Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran , , Arabipoor، Arezoo نويسنده Endocrinology and Female Infertility Department, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran , , Karimian، Leili نويسنده Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran , , Mirzaagha، Elaheh نويسنده , , Chehrazi، Mohammad نويسنده Department of biostatistics and epidemiology, Tehran university of medical sciences, Tehran, Iran ,
Abstract :
Background: To compare the pregnancy outcomes after two embryos versus three embryos
transfers (ETs) in women undergoing in vitro fertilization (IVF)/intracytoplasmic
sperm injection (ICSI) cycles.
Materials and Methods: This retrospective study was performed on three hundred eighty
seven women with primary infertility and with at least one fresh embryo in good quality
in order to transfer at each IVF/ICSI cycle, from September 2006 to June 2010. Patients
were categorized into two groups according to the number of ET as follows: ET2 and ET3
groups, indicating two and three embryos were respectively transferred. Pregnancy outcomes
were compared between ET2 and ET3 groups. Chi square and student t tests were
used for data analysis.
Results: Clinical pregnancy and live birth rates were similar between two groups. The
rates of multiple pregnancies were 27 and 45.2% in ET2 and ET3 groups, respectively.
The rate of multiple pregnancies in young women was significantly increased when triple
instead of double embryos were transferred. Logistic regression analysis indicated
two significant prognostic variables for live birth that included number and quality of
transferred embryos; it means that the chance of live birth following ICSI treatment
increased 3.2-fold when the embryo with top quality (grade A) was transferred, but the
number of ET had an inverse relationship with live birth rate; it means that probability
of live birth in women with transfer of two embryos was three times greater than those
who had three ET.
Conclusion: Due to the difficulty of implementation of the elective single-ET technique
in some infertility centers in the world, we suggest transfer of double instead of triple embryos
when at least one good quality embryo is available for transfer in women aged 39
years or younger. However, to reduce the rate of multiple pregnancies, it is recommended
to consider the elective single ET strategy.
