Impact of reducing the number of embryos transferred from three to two in women under the age of 35 who produced three or more high-quality embryos

Objective: To investigate the effect of a reduction in the number of good-quality embryos transferred in patients <35 years of age on pregnancy and multiple pregnancy rate. Design: Prospective observational study with historical controls. Setting: Academic tertiary referral unit. Patient(s): Three hundred eight patients <35 years of age undergoing IVF-ET. Intervention(s): For patients who had three or more good quality embryos available for transfer, those in group 1 were given the option to have either two or three embryos replaced, whereas those in group 2 were allowed a maximum of two embryos transferred. In both groups, patients who had less than three good-quality embryos had the option to have three embryos transferred. Main Outcome Measure(s): Pregnancy and multiple pregnancy rates. Result(s): Patients in group 1, compared with those in group 2, had significantly more embryos (3 vs. 2) of significantly higher cumulative embryo score (31 vs. 24) transferred. This resulted in significantly higher multiple (57.8% vs. 30.8%) and triplet (15.6% vs. 1.4%) pregnancy rates in group 1. However, no difference in overall clinical pregnancy rate (37.2% vs. 41.2%) or live birth rate (28.1% vs. 29.4%) was observed between group 1 and 2. Conclusion(s): In women <35 years of age, who have three or more good-quality embryos available for transfer, a maximum of two embryos should generally be transferred. (Fertil Steril (R) 2000;74:820-3. (C) 2000 by American Society for Reproductive Medicine.).