A Cohort Study to examine the Result of Transferring a Poor Quality Embryo not Suitable for Freezing along with a Good Quality Embryo?

Objective: To improve the live birth rate and multiple birth rates, we created a strategy to balance the benefits/risks of embryo transfer approaches, in which a combination of a highscore embryo and a transferable lower-score embryo were transferred.

Design: Retrospective analysis.

Setting: A single university medical center.

Population or Sample: We performed a cohort study of 3,830 patients receiving first cycle of IVF /ICSI in the Reproduction center of Nanjing Medical University.

Methods: To compare the outcomes of three approaches embryonic transfer strategies: (1) elective single embryo transfer (eSET), (2) double embryo transfer 1 (DET1) with a high-score embryo and a low-score transferable embryo, and (3) double embryo transfer 2 (DET2) with two high-score embryos.

Results: For the three groups, the clinical pregnancy rate per cycle was 32.1%, 49.4% and 63.2% respectively. Pregnancy resulting in at least one live birth occurred in 659 of 1523 women (43.3%) in the (DET1) group as compared with 152 of 468 women (28.8%) in the eSET group and 1017 of 1839
women (55.3%) in the (DET2) group. The increase of live birth rate in DET1 group vs.. eSET is accompanied with a decrease in the multiple birth rates (24.7%) vs.. the DET2 group (34.1%). No significant difference was found in miscarriage rates among the three groups. The newborn characteristics were also analyzed among the three groups, no significant different was found in the newborn characteristics of singleton and twins among three groups.