Objective To compare live birth rates, blastocyst to live birth efficiency, gestational age, and birth excess weight in a large cohort of individuals undergoing solitary versus double thawed blastocyst transfer. when the analysis was limited to singletons. 38% of blastocysts transferred via solitary FBT resulted in a live created child versus only 34% with double FBT. This suggests that two solitary FBTs would result in more live created children with significantly fewer preterm births, when compared to double FBT. Conclusions Solitary FBT greatly decreased multiple and preterm birth risk while providing excellent live birth rates. Patients should be counseled that a higher overall quantity of live created children per couple can be expected when thawed blastocysts are transferred one at a time. Support Intramural Study System and the Program in Reproductive and Adult Endocrinology, NICHD, NIH. embryo transfer (6,11,12, 13, Rabbit Polyclonal to GPR133 14). However, there is a paucity of data comparing solitary versus double frozen-thawed blastocyst transfer, and study endpoints have been limited to pregnancy outcomes (medical pregnancy, live birth, multiple birth, miscarriage, and ectopic) (15, 16). Recently, there has been a call for more substantial reporting of neonatal results as opposed to ART cycle end result only (17, 18). Our goal was to compare live birth rates, blastocyst-to-live birth effectiveness, clinical pregnancy and multiple pregnancy Purvalanol B rates, as well as preterm birth and birth excess weight in a large cohort of individuals undergoing solitary versus double vitrified-thawed blastocyst transfer. Materials and methods Study Design We performed a retrospective cohort study of all autologous solitary and double vitrified-thawed blastocyst transfers with known live-birth results performed at our center from January 2009 through April 2012. The study was performed in the Shady Grove Fertility and Reproductive Technology Center in Rockville, Maryland. Schulman Associates Institutional Review Table authorized the retrospective review and analysis of data collected during routine medical care. Individuals All transfers of one or two autologous vitrified-warmed blastocysts from January 2009 through April 2012 were analyzed. Transfers of more than two embryos were excluded. Vitrification/Warming Modified Gardner and Schoolcraft grading was used to assess developing blastocysts (19). One of two senior embryologists examined all Purvalanol B embryo grading, as is definitely routine medical practice at our center. Supernumerary blastocysts with an inner cell mass/trophectoderm grade of greater than or equal to BB by day time 5 or 6 post oocyte retrieval underwent vitrification. On the period of the study, all embryo cryopreservation-thawing at our center was performed via a vitrification-warming method, performed as previously explained (20). Endometrial preparation protocol Individuals underwent ovarian and uterine suppression using combined hormonal oral contraceptive pills. After baseline hormonal assessment and transvaginal ultrasound documenting no ovarian cysts and a thin endometrium, individuals were started on intramuscular estradiol valerate 4 mg every third day time. When serum estradiol reached a level greater than 200 pg/mL and the endometrial double thickness was greater than or equal to 8mm on transvaginal ultrasound, individuals were started on 50mg daily intramuscular progesterone in oil. Embryo selection Quantity of blastocysts transferred was determined by individuals and their physicians as per routine medical practice. Decisions concerning the number of cryopreserved blastocysts to transfer at our center are generally made based on a number of factors, including but not limited to, age Purvalanol B of the patient at the time of cryopreservation, prior birth history; earlier unsuccessful embryos transfers; the outcome of new embryo transfer cycles from which cryopreserved embryos were derived; the number of cryopreserved embryos available; medical and uterine factors; and infertility analysis. Though these are the primary factors generally regarded as in counseling, they Purvalanol B did not all result in statistically confirmed variations in quantity of embryos transferred. Single embryo transfers were more likely to be performed in individuals with a history of previous birth (both in general and specifically in the cycle from which cryopreserved embryos were derived), with fewer earlier failed embryo transfers, and with uterine element infertility. Solitary embryo transfers were also more common among individuals with fewer cryopreserved embryos available, in part because in some cases, lack of multiple embryos.