One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients.

Autor:	Peregrino PFM; Centro de Reprodução Humana Monteleone, São Paulo, SP, Brazil.; Centro de Reprodução Humana 'Governador Mario Covas', Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Bonetti TCS; Centro de Reprodução Humana Monteleone, São Paulo, SP, Brazil.; Molecular Gynecology Laboratory, Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.; Centro de Neurociências e Saúde da Mulher 'Professor Geraldo Rodrigues de Lima', Neuroscience Discipline of the Department of Neurology and Neurosurgery, Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo, SP, Brazil., Gomes AP; Centro de Reprodução Humana Monteleone, São Paulo, SP, Brazil., de Martin H; Centro de Reprodução Humana Monteleone, São Paulo, SP, Brazil.; Centro de Reprodução Humana 'Governador Mario Covas', Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Soares Júnior JM; Centro de Reprodução Humana 'Governador Mario Covas', Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Baracat EC; Centro de Reprodução Humana 'Governador Mario Covas', Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Monteleone PAA; Centro de Reprodução Humana Monteleone, São Paulo, SP, Brazil.; Centro de Reprodução Humana 'Governador Mario Covas', Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia [Rev Bras Ginecol Obstet] 2022 Jun; Vol. 44 (6), pp. 578-585. Date of Electronic Publication: 2022 May 16.
DOI:	10.1055/s-0042-1743096
Abstrakt:	Objective:  It is known that the single embryo transfer (SET) is the best choice to reduce multiples and associated risks. The practice of cryopreserving all embryos for posterior transfer has been increasingly performed for in vitro fertilization (IVF) patients at the risk of ovarian hyperstimulation syndrome or preimplantation genetic testing for aneuploidy. However, its widespread practice is still controverse. The aim of this study was to evaluate how effective is the transfer of two sequential SET procedures compared with a double embryo transfer (DET) in freeze-only cycles. Methods:  This retrospective study reviewed 5,156 IVF cycles performed between 2011 and 2019, and 506 cycles using own oocytes and freeze-only policy with subsequent elective frozen-thawed embryo transfers (eFET) were selected for this study. Cycles having elective SET (eSET, n = 209) comprised our study group and as control group we included cycles performed with elective DET (eDET, n = 291). In the eSET group, 57 couples who had failed in the 1 st eSET had a 2 nd eFET, and the estimated cumulative ongoing pregnancy rate was calculated and compared with eDET. Results:  After the 1 st eFET, the ongoing pregnancy rates were similar between groups (eSET: 35.4% versus eDET: 38.5%; p  = 0.497), but the estimated cumulative ongoing pregnancy rate after a 2 nd eFET in the eSET group (eSET + SET) was significantly higher (48.8%) than in the eDET group ( p  < 0.001). Additionally, the eSET + SET group had a 2.7% rate of multiple gestations, which is significantly lower than the eDET group, with a 30.4% rate ( p  < 0.001). Conclusion:  Our study showed the association of freeze-only strategy with until up to two consecutive frozen-thawed eSETs resulted in higher success rates than a frozen-thawed DET, while drastically reducing the rate of multiple pregnancies. Competing Interests: The authors have no conflict of interests to declare. (Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu