Objective: To determine whether blastocyst transfer is of benefit to patien
ts with multiple IVF failures.
Design: Retrospective cohort study.
Setting: The George Washington University Medical Center.
Patient(s): Patients undergoing IVF between October 1, 1997, and November 3
0, 1998, who had previously undergone three or more unsuccessful IVF cycles
. Patients who had at least three embryos at the 8- to 12-cell stage availa
ble on day 3 were eligible for the study.
Intervention(s): Patients were given the option of day 3 ET (group A) or bl
astocyst transfer (group B). Main Outcome
Measure(s): Blastocyst-formation rate, clinical pregnancy rate (PR) per tra
nsfer, and implantation rate per transfer.
Result(s): Groups A and B were similar in terms of age, the number of previ
ous failed IVF cycles, fertilization rate, and the number of fertilized ooc
ytes per cycle. The blastocyst-formation rate was 51.0%. Clinical pregnancy
and implantation rates per transfer were statistically significantly highe
r in the blastocyst-transfer group. There were no multiple pregnancies afte
r blastocyst transfer.
Conclusion: Blastocyst transfer increases implantation rates and PRs in pat
ients with multiple failed IVF cycles, without increasing the risk of multi
ple pregnancy. (C) 1999 by American Society for Reproductive Medicine.