Document Detail


Elective single-embryo transfer versus double-embryo transfer in in vitro fertilization.
MedLine Citation:
PMID:  15575055     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The risks of premature birth and perinatal death are increased after in vitro fertilization. These risks are mainly due to the high incidence of multiple births, which relates to the number of embryos transferred. METHODS: We performed a randomized, multicenter trial to assess the equivalence of two approaches to in vitro fertilization with respect to the rates of pregnancy that result in at least one live birth and to compare associated rates of multiple gestation. Women less than 36 years of age who had at least two good-quality embryos were randomly assigned either to undergo transfer of a single fresh embryo and, if there was no live birth, subsequent transfer of a single frozen-and-thawed embryo, or to undergo a single transfer of two fresh embryos. Equivalence was defined as a difference of no more than 10 percentage points in the rates of pregnancy resulting in at least one live birth. RESULTS: Pregnancy resulting in at least one live birth occurred in 142 of 331 women (42.9 percent) in the double-embryo-transfer group as compared with 128 of 330 women (38.8 percent) in the single-embryo-transfer group (difference, 4.1 percentage points; 95 percent confidence interval, -3.4 to 11.6 percentage points); rates of multiple births were 33.1 percent and 0.8 percent, respectively (P<0.001). These results do not demonstrate equivalence of the two approaches in rates of live births, but they do indicate that any reduction in the rate of live births with the transfer of single embryos is unlikely to exceed 11.6 percentage points. CONCLUSIONS: In women under 36 years of age, transferring one fresh embryo and then, if needed, one frozen-and-thawed embryo dramatically reduces the rate of multiple births while achieving a rate of live births that is not substantially lower than the rate that is achievable with a double-embryo transfer.
Authors:
Ann Thurin; Jon Hausken; Torbjörn Hillensjö; Barbara Jablonowska; Anja Pinborg; Annika Strandell; Christina Bergh
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  351     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-02     Completed Date:  2004-12-08     Revised Date:  2009-11-04    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2392-402     Citation Subset:  AIM; E; IM    
Copyright Information:
Copyright 2004 Massachusetts Medical Society.
Affiliation:
From the Department of Obstetrics and Gynecology, Institute for Health of Women and Children, Sahlgrenska University Hospital, Göteborg, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adult
Birth Rate
Cryopreservation
Embryo Transfer*
Female
Fertilization in Vitro / methods
Humans
Maternal Age
Multiple Birth Offspring
Pregnancy
Pregnancy Outcome*
Pregnancy, Multiple
Sperm Injections, Intracytoplasmic
Comments/Corrections
Comment In:
N Engl J Med. 2004 Dec 2;351(23):2440-2   [PMID:  15575063 ]
N Engl J Med. 2009 Oct 29;361(18):1812-3   [PMID:  19864685 ]

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


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