Clinical Report: Comparative Analysis of Day 4 Embryo Transfer Outcomes
Overview
This study evaluates the clinical outcomes of double embryo transfer (DET) with a fully compacted morula (FCM) and a partially compacted morula (PCM) compared to single embryo transfer (SET) with FCM. The findings show no significant differences in clinical pregnancy rates, live birth rates, or cumulative live birth rates, but a higher multiple pregnancy rate was observed in the DET group.
Background
Assisted reproductive technologies (ART) have evolved to optimize embryo transfer strategies, focusing on pregnancy outcomes and risks associated with multiple pregnancies. The compaction process during the morula stage is critical for embryo quality and development. Understanding the implications of transferring morulae at different compaction stages is essential.
Data Highlights
Outcome
DET (FCM + PCM)
SET (FCM)
P-value
Clinical Pregnancy Rate
Not significantly different
Not significantly different
P > 0.05
Live Birth Rate
Not significantly different
Not significantly different
P > 0.05
Cumulative Live Birth Rate
Not significantly different
Not significantly different
P > 0.05
Multiple Pregnancy Rate
Higher
Lower
P < 0.001
Preterm Delivery Rate
OR 4.02 (95% CI 1.75–9.22)
Not applicable
P = 0.001
Key Findings
No significant differences in clinical pregnancy rate (CPR), live birth rate (LBR), and cumulative live birth rate (CLBR) between DET with FCM and PCM and SET with FCM (all P > 0.05).
DET with FCM and PCM was associated with a significantly higher multiple pregnancy rate (MPR) (P < 0.001).
Preterm delivery rate was significantly higher in the DET group (OR 4.02, 95% CI 1.75–9.22; P = 0.001).
Outcomes for patients aged <35 years were consistent with overall findings.
Exclusion of early-stage blastocysts did not alter the main study outcomes.
Clinical Implications
The findings indicate that DET with FCM and PCM does not improve overall pregnancy outcomes compared to SET with FCM, but it significantly increases the risk of multiple pregnancies and preterm deliveries.
Conclusion
In fresh cycles, DET with FCM and PCM does not yield better clinical outcomes than SET with FCM, but it does increase the risk of multiple pregnancies.
