Blastocyst transfer for multiple prior XXXX : a five year descriptive study.

@entity1 @entity2085 @entity22485 @entity177 @entity1167
@entity1 with recurrent @entity177 are generally regarded as having a poor prognosis, and when female age exceeds 35 yrs such @entity1 face a particularly @entity22485 outlook. This study reported on blastocyst transfer (BT) performed over a five-year interval in @entity1 seeking "second opinion" after multiple failed IVF cycles. Clinical features and reproductive outcomes were compared between two sets of poor-prognosis IVF @entity1 undergoing BT for the first time, the initial group underwent treatment in 2002 (n=66) and a second group presented five years later (n=392). The two clinical sets had no @entity1 in common. The 2002 group had an average of 3.5 (+/- 1.1) prior failed IVF cycles at baseline, and mean (+/- SD) @entity1 age was 36.4 (+/- 3.9) yrs. Average number of oocytes retrieved in this group was 10.4 (+/- 5.3) with a fertilisation rate of 58.8%. Although @entity1167 resulted in no transfer for 19 @entity1 (28.8%), clinical pregnancy was achieved for 59.6% of transfers. Five years later, 392 @entity1 underwent BT, but this group had an average of 4.5 (+/- 2.3) prior failed IVF cycles. Mean (+/- SD) female age was 36.0 (+/- 3.9) yrs, and the average number of oocytes retrieved in this group was 9.1 (+/- 5.4); the fertilisation rate was 59.5%. No @entity2085 were available for transfer in 99 cases (25.3%); clinical pregnancy was achieved for 50.0% of transfers. The number of @entity2085 transferred was similar in the two groups (1.6 vs. 1.3; p=0.06); the twinning rate rose slightly from 8.2% to 15.1% (p=0.12) despite an increased utilisation of single embryo transfer in 2007 (19.7% vs. 22.2%; p=0.40). Comparisons from 2002 and 2007 found no important differences between the two @entity1 groups, except for a significantly higher rate of prior failed cycles in the 2007 group (p<0.001). This refractoriness was accompanied by a somewhat reduced blastocyst cryopreservation rate in 2007, compared to 2002 (27.6% vs. 29.5%; p=0.44). Clinical pregnancy rates are not adversely affected by application of BT in @entity1 with multiple prior unsuccessful IVF cycles. For these @entity1 , our data suggest that extended embryo culture and BT should be considered. Further controlled studies are needed to document more precisely the role of BT in this sub-set of refractory IVF @entity1 .
