Do donor oocyte cycles comply with ASRM/SART embryo transfer guidelines? An analysis of 13,393 donor cycles from the SART registry

The majority of cleavage-stage transfers of donor oocytes are compliant with SART guidelines. The majority of blastocyst transfers are noncompliant, and noncompliant transfers have a greatly increased multiple pregnancy rate.

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Volume 106, Issue 3, Pages 603-607

Authors:

Kelly S. Acharya, M.D., Sanaz Keyhan, M.D., Chaitanya R. Acharya, M.S., Jason S. Yeh, M.D., Meredith P. Provost, M.D., Ph.D., James M. Goldfarb, M.D., Suheil J. Muasher, M.D.

Abstract:

Objective

To analyze donor oocyte cycles in the Society for Assisted Reproductive Technology (SART) registry to determine: 1) how many cycles complied with the 2009 American Society for Reproductive Medicine/SART embryo transfer guidelines; and 2) cycle outcomes according to the number of embryos transferred. For donor oocyte IVF with donor age <35 years, the consideration of single-embryo transfer was strongly recommended.

Design

Retrospective cohort study of United States national registry information.

Setting

Not applicable.

Patient(s)

A total of 13,393 donor-recipient cycles from 2011 to 2012.

Intervention(s)

Embryos transferred in donor IVF cycles.

Main Outcome Measure(s)

Percentage of compliant cycles, multiple pregnancy rate.

Result(s)

There were 3,157 donor cleavage-stage transfers and 10,236 donor blastocyst transfers. In the cleavage-stage cycles, 88% met compliance criteria. The multiple pregnancy rate (MPR) was significantly higher in the noncompliant cycles. In a subanalysis of compliant cleavage-stage cycles, 91% transferred two embryos and only 9% single embryos. In those patients transferring two embryos, the MPR was significantly higher (33% vs. 1%). In blastocyst transfers, only 28% of the cycles met compliance criteria. The MPR was significantly higher in the noncompliant blastocyst cohort at 53% (compared with 2% in compliant cycles).

Conclusion(s)

The majority of donor cleavage-stage transfers are compliant with current guidelines, but the transfer of two embryos results in a significantly higher MPR compared with single-embryo transfer. The majority of donor blastocyst cycles are noncompliant, which appears to be driving an unacceptably high MPR in these cycles.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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