Abstract
Purpose: To compare the incidence of monozygotic twins following blastocyst versus day-3 embryo transfer (ET).
Methods: A retrospective analysis of the outcome of assisted reproductive technology (ART) cycles utilizing blastocyst ET during 1999–2000 was compared to a similar group of patients undergoing day-3 ET during 1997–1998.
Results: Blastocyst ET was used in 75 cycles with 2.0 ± 2 embryos transferred. The comparison group consisted of 90 cycles with day-3 ET and 3.0 ± 2 embryos transferred.
Conclusions: High pregnancy rates are maintained with blastocyst ET even though fewer embryos are transferred. The rate of monozygotic twins is higher with blastocyst ET than with day-3 ET. This increase may partially negate the benefit of reduced high-order multiple gestations attributed to blastocyst ET.
Keywords: Blastocyst, in vitro fertilization, monozygotic twins, multiple pregnancies
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References
- 1.Society for Assisted Reproductive TechnologyThe American Society for Reproductive Medicine Assisted Reproductive Technology in the United States 1999 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril. 2002;71:798–807. doi: 10.1016/s0015-0282(99)00124-7. [DOI] [PubMed] [Google Scholar]
- 2.Kolibianakis EM, Devroey P. Blastocyst culture: Facts and fiction. Reprod Biomed Online. 2000;5:285–293. doi: 10.1016/s1472-6483(10)61834-2. [DOI] [PubMed] [Google Scholar]
- 3.Schoolcraft WB, Gardner DK, Lane M, Schlenker MA, Hamilton F, Meldrum DR. Blastocyst culture and transfer: Analysis of results and parameters affecting outcome in two in vitro fertilization programs. Fertil Steril. 1999;72:604–609. doi: 10.1016/s0015-0282(99)00311-8. [DOI] [PubMed] [Google Scholar]
- 4.Peramo B, Ricciarelli E, Cuadros-Fernandez JM, Huguet E, Hernandez ER. Blastocyst transfer and monozygotic twinning. Fertil Steril. 1999;72:1116–1117. doi: 10.1016/s0015-0282(99)00412-4. [DOI] [PubMed] [Google Scholar]
- 5.Rijnders PM, van Os HC, Jansen CAM. Increased incidence of monozygotic twinning following the transfer of blastocysts in human IVF/ICSI. Fertil Steril. 1998;70(1):S15–S16. [Google Scholar]
- 6.Behr B, Fisch JD, Racowsky C, Miller K, Poole R, Milki AA. Blastocyst-ET and monozygotic twinning. J Assist Reprod Genet. 2000;17:349–351. doi: 10.1023/A:1009461213139. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Gardner DK, Schoolcraft WB. In vitro culture of human blastocyst. In Towards Reproductive Certainty. In: Jansen R, Mortimer D, editors. Infertility and Genetics Beyond 1999. Carnforth: Parthenon Press; 1999. pp. 378–388. [Google Scholar]
- 8.Finberg HJ. Ultrasound evaluation in multiple gestation. In: Callen PW, editor. Ultrasonography in Obstetrics and Gynecology. Philadelphia, PA: W.B. Saunders; 1994. pp. 102–108. [Google Scholar]
- 9.Sheiner E, Har-Vardi I, Potashnik G. The potential association between blastocyst transfer and monozygotic twinning. Fertil Steril. 2001;75:217–218. doi: 10.1016/s0015-0282(00)01635-6. [DOI] [PubMed] [Google Scholar]
- 10.Alikani M, Noyes N, Cohen J, Rosenwaks Z. Monozygotic twinning in the human is associated with the zona pellucida architecture. Hum Reprod. 1994;9:1318–1321. doi: 10.1093/oxfordjournals.humrep.a138701. [DOI] [PubMed] [Google Scholar]
- 11.Schieve L, Meikle SF, Peterson HB, Jeng G, Burnett NM, Wilcox LS. Does assisted hatching pose a risk for monozygotic twinning in pregnancies conceived through in vitro fertilization? Fertil Steril. 2000;74:288–294. doi: 10.1016/s0015-0282(00)00602-6. [DOI] [PubMed] [Google Scholar]
- 12.Da Costa ALE, Abdelmassih SA, de Oliveira FA. Monozygotic twins and transfer at the blastocyst stage after ICSI. Hum Reprod. 2001;16:333–336. doi: 10.1093/humrep/16.2.333. [DOI] [PubMed] [Google Scholar]
- 13.Sills ES, Moomjy M, Zaninovic N, Veeck LL, McGee M, Palermo GD, Rosenwaks Z. Human zona pellucida micromanipulation and monozygotic twinning frequency after IVF. Hum Reprod. 2000;15:890–895. doi: 10.1093/humrep/15.4.890. [DOI] [PubMed] [Google Scholar]
- 14.Paulson RJ, Boostanfar R, Saadat P, Mor E, Tourgeman DE, Slater CC, Francis MM, Jain JK. Pregnancy in the sixth decade of life. Obstetric outcomes in women of advanced reproductive age. JAMA. 2002;288:2320–2323. doi: 10.1001/jama.288.18.2320. [DOI] [PubMed] [Google Scholar]