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The Embryos to Transfer in IVF/ICSI

"last update: 6 August 2024"  

- REFERENCES

1. Practice Committee of the American Society for Reproductive Medicine. Electronic address: ASRM@asrm.org; Practice Committee of the American Society for Reproductive Medicine. Performing the embryo transfer: a guideline. Fertil Steril. 2017 Apr;107(4):882-896. doi: 10.1016/j.fertnstert.2017.01.025. PMID: 28366416

 2.  Alteri A, Arroyo G, Baccino G, et al. ESHRE guideline: number of embryos to transfer during IVF/ICSI † ESHRE Guideline Group on the Number of Embryos to. Published online 2024. doi:10.1093/humrep/deae010

3. Guidance on the limits to the number of embryos to transfer: a committee opinion. Fertil Steril. 2021;116(3):651-654. doi:10.1016/j.fertnstert.2021.06.050

4  .Gerris JMR. Single embryo transfer and IVF/ICSI outcome: A balanced appraisal. Hum Reprod Update. 2005;11(2):105-121. doi:10.1093/humupd/dmh049

5. Wyns C, De Geyter C, Calhaz-Jorge C, et al. ART in Europe, 2017: Results generated from European registries by ESHRE. Hum Reprod Open. 2021;2021(3). doi:10.1093/hropen/hoab026

6. Theobald R, SenGupta S, Harper J. The status of preimplantation genetic testing in the UK and USA. Human Reproduction. 2021;35(4):986-998. doi:10.1093/HUMREP/DEAA034

7. Forman EJ, Hong KH, Ferry KM, et al. In vitro fertilization with single euploid blastocyst transfer: A randomized controlled trial. Fertil Steril. 2013;100(1). doi:10.1016/j.fertnstert.2013.02.056

8. Grifo JA, Hodes-Wertz B, Lee HL, Amperloquio E, Clarke-Williams M, Adler A. Single thawed euploid embryo transfer improves IVF pregnancy, miscarriage, and multiple gestation outcomes and has similar implantation rates as egg donation. J Assist Reprod Genet. 2013;30(2):259-264. doi:10.1007/s10815-012-9929-1

9. Tobias T, Sharara FI, Franasiak JM, Heiser PW, Pinckney-Clark E. Promoting the use of elective single embryo transfer in clinical practice. Fertil Res Pract. 2016;2(1). doi:10.1186/s40738-016-0024-7

10 . Gardner DK, Phil D, Surrey E, et al. Single blastocyst transfer: a prospective randomized trial. doi:10.1016/j.fertnstert.2003

11. Gerris J, De Neubourg D, Mangelschots K, Royen E Van, Van De Meerssche M, Valkenburg M. Prevention of Twin Pregnancy after In-Vitro Fertilization or Intracytoplasmic Sperm Injection Based on Strict Embryo Criteria: A Prospective Randomized Clinical Trial. Vol 14. Templeton and Morris; 1999.

12 . Martikainen H, Tiitinen A, Tomás C, et al. One versus Two Embryo Transfer after IVF and ICSI: A Randomized Study. Vol 16.; 2001.

13 . Moustafa MK, Sheded SA, El Aziz Mousta MA. Elective single embryo transfer versus double embryo transfer in assisted reproduction. Reprod Biomed Online. 2008;17(1):82-87. doi:10.1016/S1472-6483(10)60297-0

14 . Thurin A, Hausken J, Hillensjö T, et al. Elective Single-Embryo Transfer versus Double-Embryo Transfer in in Vitro Fertilization. www.nejm.org

15. Impact of Transferring a Poor Quality Embryo Along with a Good Quality Embryo on Pregnancy Outcomes in IVF:ICSI Cycles- a Retrospective Study.

16.  Theodorou E, Jones BP, Cawood S, Heath C, Serhal P, Ben-Nagi J. Adding a low-quality blastocyst to a high-quality blastocyst for a double embryo transfer does not decrease pregnancy and live birth rate. Acta Obstet Gynecol Scand. 2021;100(6):1124-1131. doi:10.1111/aogs.14088

17. Wang W, Cai J, Liu L, et al. Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients? Reproductive Biology and Endocrinology. 2020;18(1). doi:10.1186/s12958-020-00656-2

18. Park DS, Kim JW, Chang EM, Lee WS, Yoon TK, Lyu SW. Strategies in the transfer of varying grades of vitrified-warmed blastocysts in women aged over 35 years: A propensity-matched analysis. Journal of Obstetrics and Gynaecology Research. 2019;45(4):849-857. doi:10.1111/jog.13897

19. Dobson SJA, Lao MT, Michael E, Varghese AC, Jayaprakasan K. Effect of transfer of a poor quality embryo along with a top quality embryo on the outcome during fresh and frozen in vitro fertilization cycles. Fertil Steril. 2018;110(4):655-660. doi:10.1016/j.fertnstert.2018.05.010

20. Arab S, Badegiesh A, Aldhaheri S, Son WY, Dahan MH. What Are the Live Birth and Multiple Pregnancy Rates When 1 Versus 2 Low-Quality Blastocysts Are Transferred in a Cryopreserved Cycle? a Retrospective Cohort Study, Stratified for Age, Embryo Quality, and Oocyte Donor Cycles. Reproductive Sciences. 2021;28(5):1403-1411. doi:10.1007/s43032-020-00404-2

21. Chen S, Du H, Liu J, Liu H, Li L, He Y. Live birth rate and neonatal outcomes of different quantities and qualities of frozen transferred blastocyst in patients requiring whole embryo freezing stratified by age. BMC Pregnancy Childbirth. 2020;20(1). doi:10.1186/s12884-020-03353-5

22. Richter KS, Ginsburg DK, Shipley SK, et al. Factors associated with birth outcomes from cryopreserved blastocysts: experience from 4,597 autologous transfers of 7,597 cryopreserved blastocysts. In: Fertility and Sterility. Vol 106. Elsevier Inc.; 2016:354-362.e2. doi:10.1016/j.fertnstert.2016.04.022.

 23. Engmann L, Maconochie N, Tan SL, Bekir J. Trends in the Incidence of Births and Multiple Births and the Factors That Determine the Probability of Multiple Birth after IVF Treatment. Vol 16.; 2001.

24. Kupka MS, Dorn C, Richter O, Felberbaum R, Van Der Ven H. Impact of reproductive history on in vitro fertilization and intracytoplasmic sperm injection outcome: evidence from the German IVF Registry. doi:10.1016/S0015-0282(03)

25. Molloy D, Doody ML, Breen T. Second time around: A study of patients seeking second assisted reproduction pregnancies. Fertil Steril. 1995;64(3):546-551. doi:10.1016/s0015-0282(16)57790-5

26. Simon A, Ronit C, Lewin A, Mordel N, Zajicek G, Laufer N. Conception rate after in vitro fertilization in patients who conceived in a previous cycle. Fertil Steril. 1993;59(2):343-347. doi:10.1016/S0015-0282(16)55672-6

27. Bhattacharya S, Maheshwari A, Mollison J. Factors associated with failed treatment: An analysis of 121,744 women embarking on their first IVF Cycles. PLoS One. 2013;8(12). doi:10.1371/journal.pone.0082249

28. Lintsen AME, Eijkemans MJC, Hunault CC, et al. Predicting ongoing pregnancy chances after IVF and ICSI: A national prospective study. Human Reproduction. 2007;22(9):2455-2462. doi:10.1093/humrep/dem183

29.  McLernon DJ, Steyerberg EW, Te Velde ER, Lee AJ, Bhattacharya S. Predicting the chances of a live birth after one or more complete cycles of in vitro fertilisation: Population based study of linked cycle data from 113 873 women. BMJ (Online). 2016;355. doi:10.1136/bmj.i5735

30. Roberts SA, Hirst WM, Brison DR, Vail A. Embryo and uterine influences on IVF outcomes: An analysis of a UK multi-centre cohort. Human Reproduction. 2010;25(11):2792-2802. doi:10.1093/humrep/deq213

31.  Angelini A, Brusco GF, Barnocchi N, El-Danasouri I, Pacchiarotti A,

Selman HA. Impact of physician performing embryo transfer on pregnancy rates in an assisted reproductive program. J Assist Reprod Genet 2006;23: 329–32, Level II-2

32. Bodri, D., Colodrón, M., García, D., Obradors, A., Vernaeve, V., Coll, O., 2011. Transvaginal versus transabdominal ultrasound guidance for embryo transfer in donor oocyte recipients: a randomized clinical trial. Fertil. Steril. 95, 2263–2268, 2268.e1.

33.  Karavani, G., Ben-Meir, A., Shufaro, Y., Hyman, J.H., Revel, A., 2017. Transvaginal ultrasound to guide embryo transfer: a randomized controlled trial. Fertil. Steril. 107, 1159–1165

34. Porat, N., Boehnlein, L.M., Schouweiler, C.M., Kang, J., Lindheim, S.R., 2010. Interim analysis of a randomized clinical trial comparing abdominal versus transvaginal ultrasound-guided embryo transfer. J. Obstet. Gynaecol. Res. 36,384–392.

35. Sundstro¨m P, Wramsby H, Persson PH, Liedholm P. Filled bladder sim-   . plifies human embryo transfer. Br J Obstet Gynaecol 1984;91:506–507 Tıras B, Cenksoy PO. Practice of embryo transfer: recommendations during and after. Semin Reprod Med 2014;32:291–296

36. Lewin A, Schenker JG, Avrech O, Shapira S, Safran A, Friedler S. The . role of uterine straightening by passive bladder distension before . embryo transfer in IVF cycles. J Assist Reprod Genet 1997;14:32–34. 

37.  Lewin A, Schenker JG, Avrech O, Shapira S, Safran A, Friedler S. The . role of uterine straightening by passive bladder distension before . embryo transfer in IVF cycles. J Assist Reprod Genet 1997;14:32–34. 

38.  Abou-Setta AM, Mansour RT, Al-Inany HG, Aboulghar MM, Aboulghar MA, Serour GI. Among women undergoing embryo transfer, is the probability of pregnancy and live birth improved with ultrasound guidance over clinical touch alone? A systemic re- view and meta-analysis of prospective randomized trials. Fertil Steril 2007;88:333–341.

39. Abou-Setta A.M. Al-Inany H.G. Mansour R.T. Serour G.I. Aboulghar M.A. Soft versus firm embryo transfer catheters for assisted reproduction: a systematic review and meta-analysis.Hum Reprod. 2005; 20 (Level III): 3114-3121

40.van Weering H.G. Schats R. McDonnell J. Vink J.M. Vermeiden J.P. Hompes P.G. The impact of the embryo transfer catheter on the pregnancy rate in IVF.Hum Reprod. 2002; 17 (Level I): 666-670.

41.Ghazzawi IM, Al-Hasani S, Karaki R, Souso S. Transfer technique and catheter choice influence the incidence of transcervical embryo expulsion and the outcome of IVF. Hum Reprod 1999;14:677–82, Level I.

42. van der Ven H, Diedrich K, Al-Hasani S, Pless V, Krebs D. The effect of general anaesthesia on the success of embryo transfer following human in- vitro fertilization. Hum Reprod 1988;3(Suppl 2):81–3.

43.Coroleu B. Barri P.N. Carreras O. Martinez F. Parriego M. Hereter L. et al.The influence of the depth of embryo replacement into the uterine cavity on implantation rates after IVF: a controlled, ultrasound-guided study. Hum Reprod. 2002; 17 (Level I): 341-346

44. Franco Jr., J.G. Martins A.M. Baruffi R.L. Mauri A.L. Petersen C.G. Felipe V. et al.Best site for embryo transfer: the upper or lower half of endometrial cavity?.Hum Reprod. 2004; 19 (Level I): 1785-1790

45.  Kwon H. Choi D.H. Kim E.K. Absolute position versus relative position in embryo transfer: a randomized controlled trial.Reprod Biol Endocrinol. 2015; 13 (Level I): 78

46. Pacchiarotti A. Mohamed M.A. Micara G. Tranquilli D. Linari A. Espinola S.M. et al.The impact of the depth of embro replacement on IVF outcome.J Assist Reprod Genet. 2007; 24 (Level I): 189-193.

47. Abdelmassih VG, Neme RM, Dozortsev D, Abdelmassih S, Diamond MP, Abdelmassih R. Location of the embryo-transfer catheter guide before the internal uterine os improves the outcome of in vitro fertilization. Fertil Steril 2007;88:499–503, Level II-2.

48. Brook N. Khalaf Y. Coomarasamy A. Edgeworth J. Braude P. A randomized controlled trial of prophylactic antibiotics (co-amoxiclav) prior to embryo transfer.Hum Reprod. 2006; 21 (Level I): 2911-2915

49. Kroon B. Hart R.J. Wong B.M. Ford E. Yazdani A. Antibiotics prior to embryo transfer in ART.Cochrane Database Syst Rev. 2012; (Level III): Cd008995

50.D'Angelo A, Panayotidis C, Amso N, Marci R, Matorras R, Onofriescu M, Turp AB, Vandekerckhove F, Veleva Z, Vermeulen N. et al.; ESHRE Working Group on Ultrasound in ART. Recommendations for good practice in ultrasound: oocyte pick up. Hum Reprod Open2019;2019:hoz025.

51. Sharif K, Afnan M, Lashen H, Elgendy M, Morgan C, Sinclair L. Is bed rest following embryo transfer necessary? Fertil Steril 1998;69:478–81, Level II-3.

52. Gaikwad S, Garrido N, Cobo A, Pellicer A, Remohi J. Bed rest after embryo transfer negatively affects in vitro fertilization: a randomized controlled clinical trial. Fertil Steril 2013;100:729–35, Level I.

53.Moini A, Kiani K, Bahmanabadi A, Akhoond M, Akhlaghi A.. Improvement in pregnancy rate by removal of cervical discharge prior to embryo transfer in ICSI cycles: a randomised clinical trial. Aust N Z J Obstet Gynaecol 2011;51:315–320. 

54.Craciunas L, Tsampras N, Fitzgerald C.. Cervical mucus removal before embryo transfer in women undergoing in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril 2014;101:1302–1307.

55.Derks RS, Farquhar C, Mol BWJ, Buckingham K, Heineman MJ.. Techniques for preparation prior to embryo transfer. Cochrane Database of Systematic Reviews 2009;4:CD007682.

56. Martinez F. Coroleu B. Parriego M. Carreras O. Belil I. Parera N. et al. Ultrasound-guided embryo transfer: immediate withdrawal of the catheter versus a 30 second wait.Hum Reprod. 2001; 16 (Level I): 871-874

57.Sroga J.M. Montville C.P. Aubuchon M. Williams D.B. Thomas M.A. Effect of delayed versus immediate embryo transfer catheter removal on pregnancy outcomes during fresh cycles.Fertil Steril. 2010; 93 (Level II-2): 2088-2090

58.  Alteri A, Arroyo G, Baccino G, et al. ESHRE guideline: number of embryos to transfer during IVF/ICSI † ESHRE Guideline Group on the Number of Embryos to. Published online 2024. doi:10.1093/humrep/deae010

59. Guidance on the limits to the number of embryos to transfer: a committee opinion. Fertil Steril. 2021;116(3):651-654. doi:10.1016/j.fertnstert.2021.06.050

60. Urman B, Yakin K. New Turkish legislation on assisted reproductive techniques and centres: A step in the right direction? Reprod Biomed Online. 2010;21(6):729-731. doi:10.1016/j.rbmo.2010.06.030

61. Practice Committee of the American Society for Reproductive Medicine. Electronic address: ASRM@asrm.org; Practice Committee of the American Society for Reproductive Medicine. Performing the embryo transfer: a guideline. Fertil Steril. 2017 Apr;107(4):882-896. doi: 10.1016/j.fertnstert.2017.01.025. PMID: 28366416.

2-896, APRIL 2017

62. Gerris JMR. Single embryo transfer and IVF/ICSI outcome: A balanced appraisal. Hum Reprod Update. 2005;11(2):105-121. doi:10.1093/humupd/dmh049

63. Forman EJ, Hong KH, Ferry KM, et al. In vitro fertilization with single euploid blastocyst transfer: A randomized controlled trial. Fertil Steril. 2013;100(1). doi:10.1016/j.fertnstert.2013.02.056

64. Grifo JA, Hodes-Wertz B, Lee HL, Amperloquio E, Clarke-Williams M, Adler A. Single thawed euploid embryo transfer improves IVF pregnancy, miscarriage, and multiple gestation outcomes and has similar implantation rates as egg donation. J Assist Reprod Genet. 2013;30(2):259-264. doi:10.1007/s10815-012-9929-1

65. Gardner DK, Phil D, Surrey E, et al. Single blastocyst transfer: a prospective randomized trial. doi:10.1016/j.fertnstert.2003

66. Gerris J, De Neubourg D, Mangelschots K, Royen E Van, Van De Meerssche M, Valkenburg M. Prevention of Twin Pregnancy after In-Vitro Fertilization or Intracytoplasmic Sperm Injection Based on Strict Embryo Criteria: A Prospective Randomized Clinical Trial. Vol 14. Templeton and Morris; 1999.

67. Martikainen H, Tiitinen A, Tomás C, et al. One versus Two Embryo Transfer after IVF and ICSI: A Randomized Study. Vol 16.; 2001.

68. Moustafa MK, Sheded SA, El Aziz Mousta MA. Elective single embryo transfer versus double embryo transfer in assisted reproduction. Reprod Biomed Online. 2008;17(1):82-87. doi:10.1016/S1472-6483(10)60297-0

69.  Thurin A, Hausken J, Hillensjö T, et al. Elective Single-Embryo Transfer versus Double-Embryo Transfer in in Vitro Fertilization. www.nejm.org

70. Penzias A, Bendikson K, Butts S, et al. Guidance on the limits to the number of embryos to transfer: a committee opinion. Fertil Steril. 2017;107(4):901-903.

71. Engmann L, Maconochie N, Tan SL, Bekir J. Trends in the Incidence of Births and Multiple Births and the Factors That Determine the Probability of Multiple Birth after IVF Treatment. Vol 16.; 2001.

72. Kupka MS, Dorn C, Richter O, Felberbaum R, Van Der Ven H. Impact of reproductive history on in vitro fertilization and intracytoplasmic sperm injection outcome: evidence from the German IVF Registry. doi:10.1016/S0015-0282(03)

73. Molloy D, Doody ML, Breen T. Second time around: A study of patients seeking second assisted reproduction pregnancies. Fertil Steril. 1995;64(3):546-551. doi:10.1016/s0015-0282(16)57790-5

74. Simon A, Ronit C, Lewin A, Mordel N, Zajicek G, Laufer N. Conception rate after in vitro fertilization in patients who conceived in a previous cycle. Fertil Steril. 1993;59(2):343-347. doi:10.1016/S0015-0282(16)55672-6

75. Bhattacharya S, Maheshwari A, Mollison J. Factors associated with failed treatment: An analysis of 121,744 women embarking on their first IVF Cycles. PLoS One. 2013;8(12). doi:10.1371/journal.pone.0082249

76.  Lintsen AME, Eijkemans MJC, Hunault CC, et al. Predicting ongoing pregnancy chances after IVF and ICSI: A national prospective study. Human Reproduction. 2007;22(9):2455-2462. doi:10.1093/humrep/dem183

77. McLernon DJ, Steyerberg EW, Te Velde ER, Lee AJ, Bhattacharya S. Predicting the chances of a live birth after one or more complete cycles of in vitro fertilisation: Population based study of linked cycle data from 113 873 women. BMJ (Online). 2016;355. doi:10.1136/bmj.i5735

78. Roberts SA, Hirst WM, Brison DR, Vail A. Embryo and uterine influences on IVF outcomes: An analysis of a UK multi-centre cohort. Human Reproduction. 2010;25(11):2792-2802. doi:10.1093/humrep/deq213