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Hum. Reprod. Advance Access published online on July 8, 2004

Human Reproduction, doi:10.1093/humrep/deh398
© 2004 by European Society of Human Reproduction and Embryology
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Received December 22, 2003
Revised March 17, 2004
Accepted June 9, 2004

Article

Pregnancy outcome after blastocyst transfer as compared to early cleavage stage embryo transfer

Peter Schwärzler 1*, Herbert Zech 2, Margherita Auer 1, Karin Pfau 1, Georg Göbel 3, Pierre Vanderzwalmen 2, Nicolas Zech 2

1 Department of Obstetrics and Gynecology, University of Innsbruck, Innsbruck, Austria
2 Institute for Reproductive Medicine and Endocrinology, Bregenz, Innsbruck, Austria
3 Institute for Biostatistics and Documentation, University of Innsbruck, Innsbruck, Austria

* To whom correspondence should be addressed. E-mail: peter.schwarzler{at}uibk.ac.at.


   Abstract

BACKGROUND: Retrospective cohort study to evaluate differences in outcome when embryo transfer was performed either on day 2-3 (cleavage stage, CS-group) or on day 4-5 (blastocyst stage, BS-group). METHODS: A total of 1259 consecutive cycles yielding 500 live born babies performed at a single centre in Bregenz, Austria, were included. Main outcome measures were implantation and (multiple) pregnancy rates and neonatal outcome including birth defects. RESULTS: Total Pregnancy rate was 44% vs 28% (P<0.001) and the total ‘take home baby rate’ was 37% vs 22% in the BS-group and the CS-group, respectively. Rate of multiple gestations (34% vs 17%, P=0.001) was significantly higher among the BS-group, resulting in a higher rate of preterm deliveries <36 weeks (26% vs 17%, P=0.045). Female factor causing infertility (40% vs 21%, P<0.001) was significantly higher among the BS-group. For the CS-group, rate of singleton pregnancies (83% vs 66%, P=0.001) and idiopathic cause of infertility (34% vs 22%, P=0.012) were significantly higher. No statistically significant differences were found in sex, Caesarean section rate, Apgar score and umbilical artery pH-values, total mean birth weight, admission rate to intensive care unit, days of hospitalization and number of minor and major birth defects. CONCLUSIONS: Our data suggest that blastocyst transfer may lead to a higher pregnancy rate with an overall better take-home baby rate (THBR) at the cost of higher rates of multiples and preterm deliveries.

Keywords: ART; birth defect; blastocyst transfer; early cleavage stage; pregnancy outcome.
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M. Montag and H. van der Ven
Pregnancy outcome after blastocyst transfer as compared to early cleavage stage embryo transfer
Hum. Reprod., June 1, 2005; 20(6): 1746 - 1747.
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