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Reduction in multiple pregnancy rate in donor oocyte–recipient gestational carrier (GC) in vitro fertilization (IVF) cycles in the USA with single-embryo transfer and preimplantation genetic testing

  • Assisted Reproduction Technologies
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Abstract

Purpose

To evaluate the utilization of single-embryo transfer (SET) and preimplantation genetic testing (PGT) in gestational carrier IVF cycles in the USA with donor oocyte and examine the impact on live birth and multiple gestation.

Methods

Retrospective cohort study using the Society of Assisted Reproductive Technology (SART) clinic database of 4776 donor oocyte–recipient IVF cycles in which a GC was used. The cycles were separated into 4 groups by use of PGT and number of embryos transferred as follows: (1) PGT and single-embryo transfer (PGT-SET); (2) PGT and multiple embryo transfer (PGT-MET); (3) no PGT and SET (NoPGT-SET); (4) no PGT and MET (NoPGT-MET). Primary outcomes were live birth rate (LBR) and multiple pregnancy rate (MPR).

Results

More than one blastocyst was transferred in 48.7% (2323/4774) of the cycles. When ≥1 blastocyst was transferred, with or without the use of PGT, the MPR was 45.5% and 42.0%, respectively. In comparison, in the PGT-SET and NoPGT-SET groups, the MPR was 1.4% (8/579) and 3.3% (29/883), respectively. Live birth rates increased with the use of PGT-A and with MET.

Conclusion

This study shows that SET, with or without PGT, is associated with a significantly reduced MPR in donor oocyte–recipient GC IVF cycles while maintaining high LBR. It also demonstrates that many infertility centers in the USA are not adhering to ASRM embryo transfer guidelines. Our findings highlight an opportunity to increase GC safety, which ultimately may lead to widened access to this increasingly restricted service outside the USA.

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Acknowledgements

We would like to thank the physicians and nursing staff at CARS for their support.

Availability of data and material

The data underlying this article will be shared on reasonable request to the corresponding author.

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Authors and Affiliations

  1. Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Road, Farmington, CT, 06032, USA

    Reeva Makhijani, Madeline Coulter, Arti Taggar, Prachi Godiwala, David O’Sullivan, John Nulsen, Lawrence Engmann, Claudio Benadiva & Daniel Grow

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  1. Reeva Makhijani
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  2. Madeline Coulter
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  3. Arti Taggar
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  4. Prachi Godiwala
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  5. David O’Sullivan
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  6. John Nulsen
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  7. Lawrence Engmann
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  8. Claudio Benadiva
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  9. Daniel Grow
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Contributions

R Makhijani: participated in study conception and design and execution, data analysis, manuscript drafting and critical discussion, and final approval of manuscript.

M Coulter: participated in study conception and design, critical discussion, and final approval of manuscript.

A Taggar: participated in study conception and design, critical discussion, and final approval of manuscript.

P Godiwala: participated in study conception and design, critical discussion, and final approval of manuscript.

D O’Sullivan: participated in study conception and design, data analysis, critical discussion, and final approval of manuscript.

J Nulsen: participated in study conception and design, critical discussion, and final approval of manuscript.

L Engmann: participated in study conception and design, critical discussion, and final approval of manuscript.

C Benadiva: participated in study conception and design, critical discussion, and final approval of manuscript.

D Grow: participated in study conception and design and execution, data analysis, manuscript drafting and critical discussion, and final approval of manuscript.

All authors approved the final version and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Daniel Grow.

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This study was deemed as not meeting criteria for human subject research and therefore did not require IRB approval.

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The authors declare no competing interests.

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Makhijani, R., Coulter, M., Taggar, A. et al. Reduction in multiple pregnancy rate in donor oocyte–recipient gestational carrier (GC) in vitro fertilization (IVF) cycles in the USA with single-embryo transfer and preimplantation genetic testing. J Assist Reprod Genet 38, 1441–1447 (2021). https://doi.org/10.1007/s10815-021-02112-5

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  • DOI: https://doi.org/10.1007/s10815-021-02112-5

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