Document Detail


Elective single-embryo transfer in women aged 40-44 years.
MedLine Citation:
PMID:  23175499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY QUESTION: Is an elective single-embryo transfer (eSET) policy feasible for women aged 40 or older?
SUMMARY ANSWER: For older women (aged 40-44 years) with a good prognosis, an eSET policy can be applied with acceptable cumulative clinical pregnancy rates and live birth rates.
WHAT IS KNOWN ALREADY: Various studies have shown the effectiveness of eSET in women aged <35 years with high cumulative pregnancy rates and low rates of multiple births.
STUDY DESIGN, SIZE, DURATION: This retrospective cohort study included 628 women treated between 2000 and 2009.
PARTICIPANTS, SETTING, METHODS: Women aged 40-44 years underwent a fresh cycle of IVF or ICSI treatment with eSET (n = 264) or double-embryo transfer (DET) (n = 364). In the subsequent frozen-thawed embryo transfer cycles, SET/DET was performed in both groups according to the number of embryos available and the opinion of the couple. The study was performed at the Family Federation of Finland Helsinki Fertility Clinic.
MAIN RESULTS AND THE ROLE OF CHANCE: In the fresh cycles, the clinical pregnancy rates were 23.5 and 19.5% in the eSET and DET groups, respectively, and live birth rates were 13.6 and 11.0%, respectively. In the fresh cycles with eSET, there were no twin pregnancies, but in the DET group, there were three sets of twins (7.5%). The cumulative clinical pregnancy rates per oocyte retrieval were 37.1 and 24.2% in the eSET and DET groups, respectively (P < 0.001), and the cumulative live birth rates were 22.7 and 13.2%, respectively (P = 0.002). Cumulative twin rates were 6.7% (n = 4) in the eSET group and 8.3% (n = 4) in the DET group (P = 0.726). All of the twin pregnancies in the eSET group resulted from frozen and thawed DET embryo transfer cycles.
LIMITATIONS: The characteristics of the two patients groups are not comparable because the suitability of eSET was individually assessed by a clinician based on both clinical prognostic factors and the outcome of IVF or ICSI, i.e. the number and quality of embryos.
WIDER IMPLICATIONS OF THE FINDINGS: This study may be generalized to IVF units having experience in eSET and cryopreservation.
Authors:
M Niinimäki; A-M Suikkari; S Mäkinen; V Söderström-Anttila; H Martikainen
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Publication Detail:
Type:  Journal Article     Date:  2012-11-22
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  28     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-16     Completed Date:  2013-07-25     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  331-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, University Hospital of Oulu, Oulu, Finland. maarit.niinimaki@oulu.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Birth Rate
Cryopreservation
Embryo Transfer / methods
Female
Fertilization in Vitro
Finland
Humans
Maternal Age*
Pregnancy
Pregnancy Rate*
Pregnancy, Multiple*
Retrospective Studies
Single Embryo Transfer / methods*
Comments/Corrections
Comment In:
Hum Reprod. 2013 Feb;28(2):294-7   [PMID:  23175498 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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