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The influence of prior embryo transfer failure on subsequent pregnancy outcomes in assisted reproductive technology (ART) remains uncertain.
After failed single blastocyst transfer, repeat single blastocyst transfer achieves comparable pregnancy and live birth rates to double embryo transfer while diminishing the chances of multiple pregnancy.
The influence of prior embryo transfer failure on subsequent pregnancy outcomes in assisted reproductive technology (ART) remains uncertain. In particular, limited evidence exists regarding the optimal embryo transfer strategy following a failed elective single blastocyst transfer (SBT). This study compared reproductive outcomes between repeat SBT and double high-quality cleavage-stage embryo transfer (DC-ET) in women undergoing ART after an initial SBT failure.
In this retrospective cohort study, 263 women undergoing a second frozen–thawed embryo transfer after failed SBT were analyzed. Participants were stratified into SBT or DC-ET groups according to the number and developmental stage of embryos transferred. Key IVF outcome measures encompassed clinical pregnancy rate, embryo implantation rate, live birth rate, multiple pregnancy rate, and pregnancy loss rate.
Patient baseline and clinical characteristics were comparable between the DC-ET group (n = 122) and the SBT group (n = 141). Although the DC-ET group had fewer available blastocysts due to limited blastocyst culture, the implantation rate was markedly more in the SBT group than in the DC-ET group. Despite this advantage, clinical pregnancy rates and live birth rates were same between the two approaches. Importantly, the risk of multiple pregnancy was markedly lower in women undergoing single blastocyst transfer, reinforcing its safety benefit in ART practice.
Following failure of an initial SBT, repeat elective SBT offered comparable pregnancy and live birth outcomes to double cleavage-stage embryo transfer, while reducing the likelihood of multiple gestations. These findings support the continued usage of single embryo transfer in IVF, emphasizing its role in optimizing ART success rates, improving maternal–fetal safety, and aligning with global recommendations to minimize multiple pregnancies.
Clinical and Experimental Obstetrics & Gynecology
Pregnancy Outcomes of Double-Cleavage Embryos and Single Blastocyst Transfer Following Failure of the First Frozen-Thawed Embryo Transfer: A Retrospective Cohort Study
Song Li et al.
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