Abstract
Objective
To evaluate the efficacy of sequential transfer that one cleavage-stage embryo on
day 3 and one blastocyst on day 5 are sequentially transferred in the same treatment
cycle over conventional day 3 embryo transfer and blastocyst transfer in patients
with repeated implantation failure (RIF).
Study Design: 2836 frozen embryo transfer (FET) cycles in patients with RIF were divided
into three groups according to female age: < 35, 35-39 and > 39 years old groups,
and four groups depending on the number and period of embryo transferred: two day
3 embryo, two blastocyst, single blastocyst and sequential transfer groups; Pregnancy
outcomes including implantation rate (IR), clinical pregnancy rate (CPR), abortion
rate (AR), ectopic pregnancy rate (EPR), multiple pregnancy rate (MPR), live birth
rate (LBR) and neonatal characteristics from all the groups were assessed.
Results
Sequential transfer caused a significant increase in the IR, CPR and LBR over two
day 3 embryo transfer and did not improve the IR, CPR and LBR over two blastocyst
transfer in patients with RIF. Sequential transfer had higher CPR, MPR and LBR and
lower IR than single blastocyst transfer. No significant differences were present
in neonatal characteristics among the transfer protocol groups. Singleton group had
a higher average gestational age and birthweight as well as a lower cesarean section
rate, preterm labor rate and low birthweight rate than twin group. Additionally, the
AR had no significant difference and the EPR of blastocyst transfer was low.
Conclusions
Sequential transfer was not an effective method to improve IR in patients with RIF,
and blastocyst transfer with higher IR was suggested. Single blastocyst transfer could
serve as an effective transfer protocol to reduce MPR.
Keywords
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Article info
Publication history
Accepted:
January 3,
2023
Received in revised form:
January 1,
2023
Received:
September 6,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier B.V.
