Is blastocyst transfer useful as an alternative treatment for patients with multiple in vitro fertilization failures?

Objective: To determine whether blastocyst transfer is of benefit to patients with multiple IVF failures. Design: Retrospective cohort study. Setting: The George Washington University Medical Center. Patient(s): Patients undergoing IVF between October 1, 1997, and November 30, 1998, who had previously undergone three or more unsuccessful IVF cycles. Patients who had at least three embryos at the 8- to 12-cell stage available on day 3 were eligible for the study. Intervention(s): Patients were given the option of day 3 ET (group A) or blastocyst transfer (group B). Main Outcome Measure(s): Blastocyst-formation rate, clinical pregnancy rate (PR) per transfer, and implantation rate per transfer. Result(s): Groups A and B were similar in terms of age, the number of previous failed IVF cycles, fertilization rate, and the number of fertilized oocytes per cycle. The blastocyst-formation rate was 51.0%. Clinical pregnancy and implantation rates per transfer were statistically significantly higher in the blastocyst-transfer group. There were no multiple pregnancies after blastocyst transfer. Conclusion: Blastocyst transfer increases implantation rates and PRs in patients with multiple failed IVF cycles, without increasing the risk of multiple pregnancy.