In vitro fertilization with single euploid blastocyst transfer: a randomized controlled trial
Eric J Forman, Kathleen H Hong, Kathleen M Ferry, Xin Tao, Deanne Taylor, Brynn Levy, Nathan R Treff, Richard T Scott Jr, Eric J Forman, Kathleen H Hong, Kathleen M Ferry, Xin Tao, Deanne Taylor, Brynn Levy, Nathan R Treff, Richard T Scott Jr
Abstract
Objective: To determine whether performing comprehensive chromosome screening (CCS) and transferring a single euploid blastocyst can result in an ongoing pregnancy rate that is equivalent to transferring two untested blastocysts while reducing the risk of multiple gestation.
Design: Randomized, noninferiority trial.
Setting: Academic center for reproductive medicine.
Patient(s): Infertile couples (n = 205) with a female partner less than 43 years old having a serum anti-Müllerian hormone level ≥ 1.2 ng/mL and day 3 FSH <12 IU/L.
Intervention(s): Randomization occurred when at least two blastocysts were suitable for trophectoderm biopsy. The study group (n = 89) had all viable blastocysts biopsied for real-time, polymerase chain reaction-based CCS and single euploid blastocyst transfer. The control group (n = 86) had their two best-quality, untested blastocysts transferred.
Main outcome measure(s): The ongoing pregnancy rate to ≥ 24 weeks (primary outcome) and the multiple gestation rate.
Result(s): The ongoing pregnancy rate per randomized patient after the first ET was similar between groups (60.7% after single euploid blastocyst transfer vs. 65.1% after untested two-blastocyst transfer; relative risk [RR], 0.9; 95% confidence interval [CI], 0.7-1.2). A difference of greater than 20% in favor of two-blastocyst transfer was excluded. The risk of multiple gestation was reduced after single euploid blastocyst transfer (53.4% to 0%), and patients were nearly twice as likely to have an ongoing singleton pregnancy (60.7% vs. 33.7%; RR, 1.8; 95% CI, 1.3-2.5).
Conclusion(s): In women ≤ 42 years old, transferring a single euploid blastocyst results in ongoing pregnancy rates that are the same as transferring two untested blastocysts while dramatically reducing the risk of twins.
Trial registration: ClinicalTrials.gov NCT01408433.
Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Source: PubMed