Is elective single-embryo transfer a viable treatment policy in in vitro maturation cycles?

Abstract

Objective: To compare the clinical outcome of single-embryo transfer (SET) with double-embryo transfer (DET) in in vitro maturation (IVM) cycles performed in patients with polycystic ovary syndrome (PCOS), and to determine which factors predict those outcomes. Design: A retrospective analysis. Setting: Private assisted reproduction center. Patient(s): One hundred and fifty-nine women with PCOS. Intervention(s): In vitro maturation with elective SET or DET conducted between September 2007 and May 2014. Main Outcome Measure(s): Live-birth rates. Result(s): Single-embryo transfer was performed in 83 patients (52.2%), and DET was performed in 76 patients (47.7%). When compared with the patients who had DET, the patients who had SET were statistically significantly younger (32.4 +/- 3.5 vs. 24.1 +/- 4.2 years) and had a shorter infertility duration (9.2 +/- 4.5 vs. 4.4 +/- 2.1 years), fewer previous ART cycles (< 2 prior attempts, 39.5% vs. 6%; R2 prior attempts, 60.5% vs. 0), fewer collected oocytes (15.1 +/- 4.6 vs. 12.6 +/- 3.8), fewer metaphase II oocytes (9.0 +/- 4.1 vs. 5.7 +/- 2.9), fewer fertilized oocytes (8.2 +/- 3.7 vs. 3.6 +/- 2.3), and a higher implantation rate (27% vs. 47%). The SET and DET groups had similar embryo quality and similar clinical pregnancy (44.6% vs. 44.7%) and live-birth rates (34.9% vs. 34.2%). Twin pregnancy rates were statistically significantly higher in the DET compared with the SET groups (9.2% vs. 2.4%). Conclusion(s): In vitro maturation is a successful assisted reproduction technique that can be an alternative to conventional in vitro fertilization in women presenting with PCOS-related infertility. Our observations suggest that SET is a feasible option to prevent multiple pregnancies while maintaining the live-birth rate. (C) 2016 by American Society for Reproductive Medicine.