Skip to main content
SpringerLink
Log in

Day 3 ET, single blastocyst transfer (SBT) or frozen-thawed embryo transfer (FET): which is preferable for high responder patients in IVF/ICSI cycles?

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To compare the clinical outcomes after day 3 embryo transfer, day 5 single blastocyst transfer (SBT) and frozen-thawed embryo transfer (FET) in high responder patients (>15 retrieved oocytes) undergoing IVF/ICSI treatment.

Methods

A retrospective analysis of three embryo transfer strategies for the high responder patients in IVF/ICSI cycles. The 1041 high responder patients diagnosed as primary infertility with more than 15 oocytes retrieved were recruited in Day 3 ET group, 308 patients with more than 15 oocytes retrieved first transferred with one blastocyst in SBT group and 425 patients with more than 15 oocytes retrieved in fresh cycle, first transferred with one frozen-thawed blastocyst were assigned in FET group.

Results

In the high responder patients, the clinical pregnancy rate after day 5 SBT was significantly lower than that of day 3 ET (43.18 % VS 57.16 %, p < 0.05). In addition, the clinical pregnant rate and implantation rate of FET cycles were significantly higher than SBT cycles (59.06 % vs. 43.18 % and 64.70 % vs. 47.40 %, p < 0.05). The multiple pregnancy rate in FET cycles was markedly lower than that of day 3 ET (2.35 % VS 34.97 %, p < 0.05).

Conclusions

FET was the preferable strategy for the high responder patients in IVF/ICSI cycles to obtain both desirable clinical outcome and lower multiple pregnancy rates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alexander GR, Kogan M, Martin J, Papiernik E. What are the fetal growth patterns of singletons, twins, and triplets in the United States? Clin Obstet Gynecol. 1998;41:114–25.

    Article  CAS  PubMed  Google Scholar 

  2. Alexander GR, Slay WM, Salihu H, Kirby RS. Fetal and neonatal mortality risks of multiple births. Obstet Gynecol Clin North Am. 2005;32:1–16.

    Article  PubMed  Google Scholar 

  3. Blondel B, Kogan MD, Alexander GR, Dattani N, Kramer MS, Macfarlane A, et al. The impact of the increasing number of multiple births on the rates of preterm birth and low birthweight: an international study. Am J Public Health. 2002;92:1323–30.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Bergh C. Single embryo transfer: a mini-review. Hum Reprod. 2005;20:323–7.

    Article  PubMed  Google Scholar 

  5. Bryan E. The impact of multiple preterm births on the family. BJOG. 2003;110 Suppl 20:24–8.

    Article  PubMed  Google Scholar 

  6. Simon C, Juna JG, Valbuena D, Peinado J, Pellicer A. Increasing uterine receptivity by decreasing estradiol levels during the preimplantation period in high responderers with the use of a follicle-stimulating hormone step-down regimen. Fertil Steril. 1998;70:234–9.

    Article  CAS  PubMed  Google Scholar 

  7. Criniti A, Thyer A, Chow G, Lin P, Klein N, Soules M. Elective single blastocyst transfer reduces twin rates without compromising pregnancy rates. Fertil Steril. 2005;84:1613–9.

    Article  PubMed  Google Scholar 

  8. Stoop D, Van Landuyt L, Camus M, Pevroey P. Should a single blastocyst transfer policy be a clinical decision or should it depend on the embryological evaluation on day 3? Reprod Bio and Endo. 2011;9:60–8.

    Article  Google Scholar 

  9. Ellison MA, Hall JE. Social stigma and compounded losses: quality-of-life issues for multiple-birth families. Fertil Steril. 2003;80:405–14.

    Article  PubMed  Google Scholar 

  10. Ellison MA, Hotamisligil S, Lee H, Rich-Edwards JW, Pang SC, Hall JE. Psychosocial risks associated with multiple births resulting from assisted reproduction. Fertil Steril. 2005;83:1422–8.

    Article  PubMed  Google Scholar 

  11. Gardner DK, Lane M. Culture and selection of viable blastocysts: a feasible proposition for human IVF? Hum Reprod Update. 1997;3:367–82.

    Article  CAS  PubMed  Google Scholar 

  12. Gardner DK, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000;73:1155–8.

    Article  CAS  PubMed  Google Scholar 

  13. Glazebrook C, Sheard C, Cox S, Oates M, Ndukwe G. Parenting stress in first-time mothers of twins and triplets conceived after in vitro fertilization. Fertil Steril. 2004;81:505–11.

    Article  PubMed  Google Scholar 

  14. Gunby J, Daya S. Assisted reproductive technologies (ART) in Canada:2001 results from the Canadian ART Register. Fertil Steril. 2005;84:590–9.

    Article  PubMed  Google Scholar 

  15. McWhinnie A. Euphoria or despair? Coping with multiple births from ART: what patients don’t tell the clinics. Hum Fertil (Camb). 2000;3:20–5.

    Article  PubMed  Google Scholar 

  16. National Center for Chronic Disease Prevention and Health Promotion, American Society for Reproductive Medicine, Society for Assisted Reproductive Technology. 2001 Assisted reproductive technology success rates: national summary and fertility clinic reports. Atlanta: Centers for Disease Control and Prevention, December 2003.

  17. Olivennes F, Golombok S, Ramogida C, Rust J. Behavioral and cognitive development as well as family functioning of twins conceived by assisted reproduction: findings from a large population study. Fertil Steril. 2005;84:725–33.

    Article  PubMed  Google Scholar 

  18. Papanikolaou E, Kolibianakis E, Tournaye H, Venetis C, Fatemi H, Tarlatzis B, et al. Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and metaanalysis. Hum Reprod. 2008;23:91–9.

    Article  PubMed  Google Scholar 

  19. Papanikolaou E, Camus M, Kolibianakis E, Van Landuyt L, Van Steirteghem A, Devroey P. In vitro fertilization with single blastocyst-stage versus single cleavage-stage embryos. N Engl J Med. 2006;354:1139–46.

    Article  CAS  PubMed  Google Scholar 

  20. Pinborg A, Loft A, Schmidt L, Andersen AN. Morbidity in a Danish national cohort of 472 IVF/ICSI twins, 1132 non-IVF/ICSI twins and 634 IVF/ICSI singletons: health-related and social implications for the children and their families. Hum Reprod. 2003;18:1234–43.

    Article  PubMed  Google Scholar 

  21. Paulson RJ, Sauer MV, Lobo RA. Embryo implantation after human in vitro fertilization: importance of endometrial receptivity. Fertil Steril. 1990;53:870–4.

    CAS  PubMed  Google Scholar 

  22. Puissant F, Van Ryssellberge M, Barlow P. Embryo scoring as a prognostic tool in IVF treatment. Hum Reprod. 1987;2:705–8.

    CAS  PubMed  Google Scholar 

  23. Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C, Thomas S. Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen-thawed embryo transfer in normal responderers. Fertil Steril. 2011;96(2):344–8.

    Article  PubMed  Google Scholar 

  24. Valbuena D, Martin J, de Pablo JL, Remohi J, Pellicer A, Simon C. Increasing levels of estradiol are deleterious to embryonic implantation because they directly affect the embryo. Fertil Steril. 2001;76:962–8.

    Article  CAS  PubMed  Google Scholar 

  25. Wright VC, Schieve LA, Reynolds MA, Jeng G. Assisted reproductive technology surveillance—United States, 2002. MMWR Surveill Summ. 2005;54:1–24.

    PubMed  Google Scholar 

Download references

Acknowledgments

This article is funded by Science research foundation item of no-earnings health vocation (201002013) and National Basic Research Program of China (973 Program) (2010CB945002).

Author information

Authors and Affiliations

  1. Center for Reproductive Medicine, Provincial Hospital Affiliated to Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China The Key laboratory for Reproductive Endocrinology of Ministry of Education, Shandong Provincial Key Laboratory of Reproductive Medicine, 324 Jingwu Road, Jinan, 250021, China

    Keliang Wu, Haibin Zhao, Hui Liu, Mei Li, Shuiying Ma, Cheng Li, Chang Liu & Zi-Jiang Chen

Authors
  1. Keliang Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Haibin Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hui Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mei Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shuiying Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Cheng Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Chang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zi-Jiang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zi-Jiang Chen.

Additional information

Capsule FET was the optimal strategy for the high responder patients in IVF/ICSI cycles to lower multiple pregnancy rates and improve clinical pregnancy rate.

Keliang Wu and Haibin Zhao contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wu, K., Zhao, H., Liu, H. et al. Day 3 ET, single blastocyst transfer (SBT) or frozen-thawed embryo transfer (FET): which is preferable for high responder patients in IVF/ICSI cycles?. J Assist Reprod Genet 31, 275–278 (2014). https://doi.org/10.1007/s10815-013-0156-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-013-0156-1

Keywords

Search

Navigation