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Advantages of the two-step embryo transfer strategy in human IVF/ICSI cycles

Published online by Cambridge University Press:  06 October 2011

Chadi Yazbeck ,
Nadia Ben Jamaa ,
André Hazout ,
Paul Cohen-Bacrie ,
Anne-Marie Junca  and
Nathalie Rougier
Chadi Yazbeck*
Affiliation:
Service de Gynécologie Obstétrique, Hôpital Bichat Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France. INSERM U1018 – CESP, 94807 Villejuif, France.
Nadia Ben Jamaa
Affiliation:
Department of Obstetrics, Gynaecology and Reproductive Medicine, IVF unit, Bichat Claude Bernard University Hospital, AP-HP, 75018 Paris, France.
André Hazout
Affiliation:
Department of Obstetrics, Gynaecology and Reproductive Medicine, IVF unit, Bichat Claude Bernard University Hospital, AP-HP, 75018 Paris, France. Department of Reproductive Biology, Eylau – La Muette IVF Clinic, 75116 Paris, France.
Paul Cohen-Bacrie
Affiliation:
Department of Reproductive Biology, Eylau – La Muette IVF Clinic, 75116 Paris, France.
Anne-Marie Junca
Affiliation:
Department of Reproductive Biology, Eylau – La Muette IVF Clinic, 75116 Paris, France.
Nathalie Rougier
Affiliation:
Department of Obstetrics, Gynaecology and Reproductive Medicine, IVF unit, Bichat Claude Bernard University Hospital, AP-HP, 75018 Paris, France.
*
All correspondence to: Chadi Yazbeck. Service de Gynécologie Obstétrique, Hôpital Bichat Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France. Tel: +33 1 40 25 77 20. Fax: +33 1 40 25 76 00. e-mail: chayazmd@hotmail.com
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Summary

The aim of this study was to evaluate the advantages of the two-step embryo transfer (ET) strategy combining a day 2/3 ET with a day 5/6 blastocyst transfer. In an observational comparative study, 400 infertile women were enrolled from two assisted reproductive technology (ART) units according to inclusion criteria: age below 42 years and at least three embryos obtained on day 2 thus allowing an extended in vitro culture. Two groups were defined according to the ET strategy adopted: group 1 had a two-step ET; and group 2 had a day 2/3 ET with (subgroup 2a) or without (subgroup 2b) blastocysts cryopreserved on day 5/6. Live birth rate was significantly higher in group 1 than in subgroups 2a and 2b (36.5% versus 29.4% and 13.4%, respectively; p < 10−3). Multiple pregnancy rates were comparable between groups. After adjusting on major prognostic factors, the two-step ET strategy was still associated with a significantly higher live birth rate than the day 2/3 ET (OR = 2.23; 95% CI: 1.32–3.77). The two-step ET provides better live birth rates than the cleavage-stage ET. It does not increase multiple pregnancy rates if the number of embryos transferred is limited. It also prevents cycle loss when embryos fail to develop into blastocysts.

Keywords

ARTblastocystextended cultureprognostic factorstwo-step embryo transfer
Type
Research Article
Information
Zygote , Volume 21 , Issue 1 , February 2013 , pp. 77 - 83
Copyright
Copyright © Cambridge University Press 2011

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References

Al-Hasani, S., Van der Ven, H., Diedrich, K., Reinecke, A., Hartje, H. & Krebs, D. (1990). [Effect of sequential embryo transfer on pregnancy following in vitro fertilization]. Geburtshilfe Frauenheilkd 50, 640–43.CrossRefGoogle ScholarPubMed
Alper, M.M., Brinsden, P., Fischer, R. & Wikland, M. (2001). To blastocyst or not to blastocyst? That is the question. Hum. Reprod. 16, 617–9.CrossRefGoogle ScholarPubMed
Ashkenazi, J., Yoeli, R., Orvieto, R., Shalev, J., Ben-Rafael, Z. & Bar-Hava, I. (2000). Double (consecutive) transfer of early embryos and blastocysts: aims and results. Fertil. Steril. 74, 936–40.CrossRefGoogle ScholarPubMed
ASRM (2006). Blastocyst culture and transfer in clinical-assisted reproduction. Fertil. Steril. 86, S89–92.CrossRefGoogle Scholar
Blake, D.A., Proctor, M. & Johnson, N.P. (2004). The merits of blastocyst versus cleavage stage embryo transfer: a Cochrane review. Hum. Reprod. 19, 2174.CrossRefGoogle ScholarPubMed
Carlone, D.L., Rider, V., Gardner, D.K. & Lane, M. (1993). Embryonic modulation of basic fibroblast growth factor in the rat uterus. Biol. Reprod. 49, 653–65.CrossRefGoogle ScholarPubMed
Emiliani, S., Delbaere, A., Devreker, F. & Englert, Y. (2005). Embryo-maternal interactive factors regulating the implantation process: implications in assisted reproductive. Reprod. Biomed. Online 10, 527–40.CrossRefGoogle ScholarPubMed
Fanchin, R., Ayoubi, J.M., Righini, C., Olivennes, F., Schonauer, L.M. & Frydman, R. (2001). Uterine contractility decreases at the time of blastocyst transfers. Hum. Reprod. 16, 1115–9.CrossRefGoogle ScholarPubMed
Fancsovits, P., Toth, L., Takacs, Z.F., Murber, A., Papp, Z. & Urbancsek, J. (2005). Early pronuclear breakdown is a good indicator of embryo quality and viability. Fertil. Steril. 84, 881–7.CrossRefGoogle ScholarPubMed
Frattarelli, J.L., Miller, K.A., Miller, B.T., Elkind-Hirsch, K. & Scott, R.T. Jr. (2008). Male age negatively impacts embryo development and reproductive outcome in donor oocyte assisted reproductive technology cycles. Fertil. Steril. 90, 97–103.CrossRefGoogle ScholarPubMed
Gardner, D.K. (2000). Blastocyst culture: toward single embryo transfers. Hum. Fertil. (Camb) 3, 229–37.CrossRefGoogle ScholarPubMed
Gardner, D.K., Schoolcraft, W.B., Wagley, L., Schlenker, T., Stevens, J. & Hesla, J. (1998). A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum. Reprod. 13, 3434–40.CrossRefGoogle ScholarPubMed
Goto, S., Takebayashi, K., Shiotani, M., Fujiwara, M., Hirose, M. & Noda, Y. (2003). Effectiveness of 2-step (consecutive) embryo transfer. Comparison with cleavage-stage transfer. J. Reprod. Med. 48, 370–4.Google ScholarPubMed
Goto, S., Shiotani, M., Kitagawa, M., Kadowaki, T. & Noda, Y. (2005). Effectiveness of two-step (consecutive) embryo transfer in patients who have two embryos on day 2: comparison with cleavage-stage embryo transfer. Fertil. Steril. 83, 721–3.CrossRefGoogle ScholarPubMed
Graham, J., Han, T., Porter, R., Levy, M., Stillman, R. & Tucker, M.J. (2000). Day 3 morphology is a poor predictor of blastocyst quality in extended culture. Fertil. Steril. 74, 495–7.CrossRefGoogle ScholarPubMed
Guerif, F., Le Gouge, A., Giraudeau, B., Poindron, J., Bidault, R., Gasnier, O. & Royere, D. (2007). Limited value of morphological assessment at days 1 and 2 to predict blastocyst development potential: a prospective study based on 4042 embryos. Hum. Reprod. 22, 1973–81.CrossRefGoogle ScholarPubMed
Guerif, F., Lemseffer, M., Bidault, R., Gasnier, O., Saussereau, M.H., Cadoret, V., Jamet, C. & Royere, D. (2009). Single day 2 embryo versus blastocyst-stage transfer: a prospective study integrating fresh and frozen embryo transfers. Hum. Reprod. 24, 1051–8.CrossRefGoogle ScholarPubMed
Levron, J., Shulman, A., Bider, D., Seidman, D., Levin, T. & Dor, J. (2002). A prospective randomized study comparing day 3 with blastocyst-stage embryo transfer. Fertil. Steril. 77, 1300–1.CrossRefGoogle ScholarPubMed
Machtinger, R., Dor, J., Margolin, M., Levron, J., Baum, M., Ferber, B., Shulman, A., Bider, D. & Seidman, D.S. (2006). Sequential transfer of day 3 embryos and blastocysts after previous IVF failures despite adequate ovarian response. Reprod. Biomed. Online 13, 376–9.CrossRefGoogle ScholarPubMed
Noci, I., Fuzzi, B., Rizzo, R., Melchiorri, L., Criscuoli, L., Dabizzi, S., Biagiotti, R., Pellegrini, S., Menicucci, A. & Baricordi, O.R. (2005). Embryonic soluble HLA-G as a marker of developmental potential in embryos. Hum. Reprod. 20, 138–46.CrossRefGoogle ScholarPubMed
Nyboe Andersen, A., Gianaroli, L. & Nygren, K.G. (2004). Assisted reproductive technology in Europe, 2000. Results generated from European registers by ESHRE. Hum. Reprod. 19, 490–503.Google ScholarPubMed
Papanikolaou, E.G., Camus, M., Kolibianakis, E.M., Van Landuyt, L., Van Steirteghem, A. & Devroey, P. (2006). In vitro fertilization with single blastocyst-stage versus single cleavage-stage embryos. N. Engl. J. Med. 354, 1139–46.CrossRefGoogle ScholarPubMed
Papanikolaou, E.G., Kolibianakis, E.M., Tournaye, H., Venetis, C.A., Fatemi, H., Tarlatzis, B. & Devroey, P. (2008). Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis. Hum. Reprod. 23, 91–9.CrossRefGoogle ScholarPubMed
Phillips, S.J., Dean, N.L., Buckett, W.M. & Tan, S.L. (2003). Consecutive transfer of day 3 embryos and of day 5–6 blastocysts increases overall pregnancy rates associated with blastocyst culture. J. Assist. Reprod. Genet. 20, 461–4.CrossRefGoogle ScholarPubMed
Racowsky, C., Jackson, K.V., Cekleniak, N.A., Fox, J.H., Hornstein, M.D. & Ginsburg, E.S. (2000). The number of eight-cell embryos is a key determinant for selecting day 3 or day 5 transfer. Fertil. Steril. 73, 558–64.CrossRefGoogle ScholarPubMed
Salumets, A., Hyden-Granskog, C., Makinen, S., Suikkari, A.M., Tiitinen, A. & Tuuri, T. (2003). Early cleavage predicts the viability of human embryos in elective single embryo transfer procedures. Hum. Reprod. 18, 821–5.CrossRefGoogle ScholarPubMed
Scholtes, M.C. & Zeilmaker, G.H. (1998). Blastocyst transfer in day-5 embryo transfer depends primarily on the number of oocytes retrieved and not on age. Fertil. Steril. 69, 78–83.CrossRefGoogle Scholar
Tesarik, J. & Greco, E. (1999). The probability of abnormal preimplantation development can be predicted by a single static observation on pronuclear stage morphology. Hum. Reprod. 14, 1318–23.CrossRefGoogle ScholarPubMed
Tomazevic, T., Korosec, S., Virant Klun, I., Drobnic, S. & Verdenik, I. (2007). Age, oestradiol and blastocysts can predict success in natural cycle IVF-embryo transfer. Reprod. Biomed. Online 15, 220–6.CrossRefGoogle ScholarPubMed
Tur-Kaspa, I., Yuval, Y., Bider, D., Levron, J., Shulman, A. & Dor, J. (1998). Difficult or repeated sequential embryo transfers do not adversely affect in-vitro fertilization pregnancy rates or outcome. Hum. Reprod. 13, 2452–5.CrossRefGoogle ScholarPubMed
Weissman, A., Biran, G., Nahum, H., Glezerman, M. & Levran, D. (2008). Blastocyst culture and transfer: lessons from an unselected, difficult IVF population. Reprod. Biomed. Online 17, 220–8.CrossRefGoogle ScholarPubMed
Wilson, M., Hartke, K., Kiehl, M., Rodgers, J., Brabec, C. & Lyles, R. (2004). Transfer of blastocysts and morulae on day 5. Fertil. Steril. 82, 327–33.CrossRefGoogle ScholarPubMed
Yazbeck, C., Madelenat, P., Ayel, J.P., Jacquesson, L., Bontoux, L.M., Solal, P. & Hazout, A. (2009). Ethanol sclerotherapy: a treatment option for ovarian endometriomas before ovarian stimulation. Reprod. Biomed. Online 19, 121–5.CrossRefGoogle ScholarPubMed