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Predictors of twin live birth following cryopreserved double embryo transfer on day 3

  • Assisted Reproduction Technologies
  • Published:
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Abstract

Purpose

To determine embryo and cycle-specific parameters associated with twin live birth in day 3 cryopreserved double embryo transfer (DET) cycles, and to propose a new prediction model for external validation.

Methods

All cycles with autologous or donor cryopreserved DET of day 3 embryos from 2002 to 2011 at a single academic institution with a singleton or twin live birth were included (n = 207). Patient characteristics, post-thaw embryo morphology and freeze-thaw parameters were compared between patients with a single and twin live birth.

Results

Demographic characteristics were similar, except that patients delivering twins were younger at age of cryopreserved embryo transfer (CET), fewer were parous and more were anovulatory. Duration of embryo storage, time in culture post-thaw, endometrial thickness and use of assisted hatching were comparable. Six predictors of twin delivery were identified: patient age <35 year at CET, intact survival of the lead embryo, resumption of mitosis, 7–8 viable cells in the non-lead embryo, transfer of a lead embryo with ≥7 cells and a sum of ≥14 viable cells in the two transferred embryos. Regression modeling predicted a step-wise increase in the probability of twins with addition of each predictor; with all six present, the risk of twins was predicted to be 53 % and with none present, the risk decreased to 6 %.

Conclusions

The six identified variables associated with twin live birth following day 3 cryopreserved DET have been applied to derive a prediction model for estimating the risk of twin delivery. External validation of the model is required prior to clinical application.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Division of Reproductive Medicine, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Daniel J. Kaser, Stacey A. Missmer, Katharine F. Correia, Mark D. Hornstein & Catherine Racowsky

  2. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA

    Stacey A. Missmer

  3. Department of Epidemiology, Harvard School of Public Health, Boston, MA, 02115, USA

    Stacey A. Missmer

  4. Gülhane Military Medical School, Department of Obstetrics and Gynecology, Center for Assisted Reproduction, Etlik, 06018, Ankara, Turkey

    S. Temel Ceyhan

Authors
  1. Daniel J. Kaser
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  2. Stacey A. Missmer
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  3. Katharine F. Correia
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  4. S. Temel Ceyhan
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  5. Mark D. Hornstein
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  6. Catherine Racowsky
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Corresponding author

Correspondence to Catherine Racowsky.

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Capsule

A prediction model has been derived to estimate an individualized risk of twin live birth following transfer of two thawed cleavage stage embryos.

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Kaser, D.J., Missmer, S.A., Correia, K.F. et al. Predictors of twin live birth following cryopreserved double embryo transfer on day 3. J Assist Reprod Genet 30, 1023–1030 (2013). https://doi.org/10.1007/s10815-013-0039-5

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  • DOI: https://doi.org/10.1007/s10815-013-0039-5

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