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Hum. Reprod. Advance Access originally published online on January 12, 2006
Human Reproduction 2006 21(5):1179-1183; doi:10.1093/humrep/dei490
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Towards defining parameters for a successful single embryo transfer in frozen cycles

R. Tang1,2, J. Catt1,3 and D. Howlett1

1 Monash IVF, Clayton, Victoria, Australia and 2 Centre for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Jinan, PR China

3 To whom correspondence should be addressed at: Monash IVF, 1/252 Clayton Rd, Clayton, Victoria 3168, Australia. E-mail: jcatt{at}monashivf.edu.au

BACKGROUND: Twin pregnancies in IVF should be avoided by transferring embryos one at a time, even for frozen cycles. In this study, we investigated the effect of blastomere lysis and cleavage in singleton frozen embryo transfer (sFET) cycles. Outcomes were compared with the transfer of two embryos in frozen transfer cycles (dFET). METHODS: A retrospective analysis was performed on 891 FET cycles, involving 404 sFET and 487 dFET cycles. RESULTS: Overall, in sFET cycles, the pregnancy and implantation rates were 8.9 and 8.7%. When blastomere lysis was more than 25% but no greater than 50%, the pregnancy and implantation rates were 3.2%. If blastomere lysis was greater than 50% there were no pregnancies. If blastomere lysis was less than 25%, but with no cleavage, the pregnancy and implantation rates were 4.1%. The results significantly improved (P = 0.007) in the group with less than 25% lysis, when cleavage occurred. The pregnancy and implantation rates for this group were 17.3 and 16.6%. This was not significantly different from unselected two embryo transfers (22 and 12.7%,P = 0.2 and 0.19, respectively). There were 21 twins with dFET (19.6% of pregnancies) and none in sFET. CONCLUSION: Both blastomere lysis and cleavage affect the outcome in sFET. To avoid the risk of twins, sFET should be considered when the embryo shows less than 25% blastomere lysis and at least one blastomere cleaves.

Key words: blastomere cleavage/blastomere lysis/cryopreservation/FET/dFET/sFET


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