Transferring Single Prescreened Embryo in IVF Offers Excellent Delivery Rates
May 8, 2013
New Orleans, LA -- Transferring a single prescreened chromosomally normal embryo during in vitro fertilization (IVF) offers delivery rates equivalent to the more standard procedure of transferring two unscreened embryos, according to new research presented today at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists. It also results in fewer twins and, thus, healthier obstetric and pediatric outcomes.
Infertility treatments such as IVF generate 18% of all twin deliveries in the US. Reducing the burden of care that these deliveries often create has been a pursuit of reproductive endocrinologists, ob-gyns, and managed care providers for some time, said lead researcher Eric J. Forman, MD, at UMDNJ-Robert Wood Johnson Medical School/Reproductive Medicine Associates of New Jersey (RMANJ) in Basking Ridge.
“The technology exists today to make single-embryo transfer the standard of care across age groups, eliminating the vast majority of complications stemming from IVF, while maintaining excellent delivery rates for couples who have struggled with infertility,” Dr. Forman said.
Dr. Forman and his team selected 175 women up to age 43 to have a single-embryo transfer (SET) with preimplantation genetic screening, or a double-embryo transfer (DET) with no screening. Pregnancy rates were equivalent between the two groups, with no twins after SET and 53% of multiples after DET. Patients undergoing SET had a longer mean gestation (38.7 vs. 37 weeks) and increased newborn birth weight than patients undergoing DET. Newborns resulting from SET had a lower rate of NICU admission and spent less total time in the NICU than those after DET. There was a trend toward more deliveries prior to 34 weeks after DET (0% vs. 17%). Results through the first 100 deliveries demonstrate a three-fold increased risk of preterm delivery after DET compared with SET.
Currently, less that 10% of IVF patients opt for SET, Dr. Forman said. This is most likely because patients feel that transferring two or more embryos offers them the best chance at a pregnancy. For many, the procedure is not covered by insurance. Dr. Forman said that as more patients learn about the success rates of SET when paired with chromosomal screening, more patients will likely choose it.
“SET with comprehensive chromosome screening has the potential to be paradigm-shifting and revolutionary in the world of IVF,” said Dr. Forman. “Patients can do SET and maintain excellent delivery rates while not taking on the treatment-related risk of multiples. And for ob-gyns, this will mean fewer high-risk pregnancies handed off to them. It can reduce the health care burden across the spectrum.”
One caveat is that the type of chromosomal screening employed in this study, which was done on fresh blastocysts, is only available at the few clinics associated with RMANJ, according to Dr. Forman. It should become more widely available soon. Currently, embryo biopsy and comprehensive chromosome screening adds an additional cost to the IVF cycle. Research is ongoing at RMANJ to determine whether the approach results in overall health care savings due to the improved obstetric outcomes when the screening is combined with SET.
This study was funded by a grant from Ferring Pharmaceuticals that covered the cost of the study subjects’ medications, as well as by RMANJ, which provided all IVF services and care for subjects.
*Wednesday Paper #3: Single Embryo Transfer with Aneuploidy Screening: Same Delivery Rate, Better Obstetrical Outcome
The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 57,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org