Clin Exp Reprod Med.  2015 Dec;42(4):169-174. 10.5653/cerm.2015.42.4.169.

Multiple pregnancy after single or multiple embryo transfer performed according to Korean guidelines

• Han EJ
• Kim SK
• Lee JR
• Jee BC
• Suh CS
• Kim SH

• KMID: 2167481
• DOI: http://doi.org/10.5653/cerm.2015.42.4.169

Abstract

OBJECTIVE
To assess compliance with Korean guidelines for embryo transfer, the possible reasons for non-compliance, and multiple pregnancies according to each specific condition in compliant cycles.
METHODS
A single-institution, retrospective study was conducted of 256 fresh in vitro fertilization cycles during 2012-2014. To assess compliance with Korean guidelines, the maximum recommended number of embryos transferred (according to criteria of age, transfer day, and presence of favorable conditions) was compared with the actual number of embryos transferred. Clinical pregnancy rate (PR) was assessed as the percentage of pregnant women resulting from each set of transfer conditions, including the number of embryos transferred. The multiple pregnancy rate (MPR) was calculated as the percentage of pregnant women with a multifetal pregnancy.
RESULTS
The compliance rate with the Korean guidelines was 96.5% (247/256). Non-compliance occurred in nine cycles owing to poor embryo quality, repeated implantation failure, or hostile endometrium. In compliant cycles, the PR was 31.2% (77/247), and the MPR was 27.3% (21/77; 20 twins and one triplet). Higher MPR was noted in two types of transfer conditions: transfer of three cleavage embryos in women aged 35-39 years with favorable conditions (66.7%; primarily from those aged 35-37 years) and transfer of two blastocysts in women aged > or =40 years with favorable conditions (50%).
CONCLUSION
Under the Korean guidelines, compliance rate was high in our center. Multiple pregnancies occurred primarily in group with favorable conditions. In high-risk groups for multiple pregnancies, reducing number of embryos transferred should be considered than suggested in the guideline.

Keyword

Embryo transfer; Guidelines; Multiple pregnancy

MeSH Terms

Blastocyst
Compliance
Embryo Transfer*
Embryonic Structures*
Endometrium
Female
Fertilization in Vitro
Humans
Pregnancy
Pregnancy Rate
Pregnancy, Multiple*
Pregnant Women
Retrospective Studies
Twins