Is elective single-embryo transfer a viable treatment policy in in vitro maturation cycles?

Elective single-embryo transfer after in vitro maturation seems a viable option for women with polycystic ovary syndrome, younger than 35 years, and undergoing their first two assisted reproduction cycles.

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Volume 106, Issue 7, Pages 1691-1695

Authors:

Safak Hatırnaz, M.D., Ebru Hatırnaz, M.D., Michael H. Dahan, M.D., Seang Lin Tan, M.D., M.B.A., Alev Ozer, M.D., Mine Kanat-Pektas, M.D., Baris Ata, M.D., M.C.T.

Abstract:

Objective

To compare the clinical outcome of single-embryo transfer (SET) with double-embryo transfer (DET) in in vitro maturation (IVM) cycles performed in patients with polycystic ovary syndrome (PCOS), and to determine which factors predict those outcomes.

Design

A retrospective analysis.

Setting

Private assisted reproduction center.

Patient(s)

One hundred and fifty-nine women with PCOS.

Intervention(s)

In vitro maturation with elective SET or DET conducted between September 2007 and May 2014.

Main Outcome Measure(s)

Live-birth rates.

Result(s)

Single-embryo transfer was performed in 83 patients (52.2%), and DET was performed in 76 patients (47.7%). When compared with the patients who had DET, the patients who had SET were statistically significantly younger (32.4 ± 3.5 vs. 24.1 ± 4.2 years) and had a shorter infertility duration (9.2 ± 4.5 vs. 4.4 ± 2.1 years), fewer previous ART cycles (<2 prior attempts, 39.5% vs. 6%; ≥2 prior attempts, 60.5% vs. 0), fewer collected oocytes (15.1 ± 4.6 vs. 12.6 ± 3.8), fewer metaphase II oocytes (9.0 ± 4.1 vs. 5.7 ± 2.9), fewer fertilized oocytes (8.2 ± 3.7 vs. 3.6 ± 2.3), and a higher implantation rate (27% vs. 47%). The SET and DET groups had similar embryo quality and similar clinical pregnancy (44.6% vs. 44.7%) and live-birth rates (34.9% vs. 34.2%). Twin pregnancy rates were statistically significantly higher in the DET compared with the SET groups (9.2% vs. 2.4%).

Conclusion(s)

In vitro maturation is a successful assisted reproduction technique that can be an alternative to conventional in vitro fertilization in women presenting with PCOS-related infertility. Our observations suggest that SET is a feasible option to prevent multiple pregnancies while maintaining the live-birth rate.


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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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