Do donor oocyte cycles comply with ASRM SART embryo transfer guidelines An analysis of 13393 donor cycles from the SART registry

Authors:
Kelly S. Acharya, M.D., Sanaz Keyhan, M.D., Chaitanya R. Acharya, M.S., Jason S. Yeh, M.D., Meredith P. Provost, M.D., Ph.D., James M. Goldfarb, M.D., Suheil J. Muasher, M.D.

Abstract:

Objective:
To analyze donor oocyte cycles in the Society for Assisted Reproductive Technology (SART) registry to determine: 1) how many cycles complied with the 2009 American Society for Reproductive Medicine/SART embryo transfer guidelines; and 2) cycle outcomes according to the number of embryos transferred. For donor oocyte IVF with donor age <35 years, the consideration of single-embryo transfer was strongly recommended. Design:
Retrospective cohort study of United States national registry information.

Setting:
Not applicable.

Patient(s):
A total of 13,393 donor-recipient cycles from 2011 to 2012.

Intervention(s):
Embryos transferred in donor IVF cycles.

Main Outcome Measure(s):
Percentage of compliant cycles, multiple pregnancy rate.

Result(s):
There were 3,157 donor cleavage-stage transfers and 10,236 donor blastocyst transfers. In the cleavage-stage cycles, 88% met compliance criteria. The multiple pregnancy rate (MPR) was significantly higher in the noncompliant cycles. In a subanalysis of compliant cleavage-stage cycles, 91% transferred two embryos and only 9% single embryos. In those patients transferring two embryos, the MPR was significantly higher (33% vs. 1%). In blastocyst transfers, only 28% of the cycles met compliance criteria. The MPR was significantly higher in the noncompliant blastocyst cohort at 53% (compared with 2% in compliant cycles).

Conclusion(s):
The majority of donor cleavage-stage transfers are compliant with current guidelines, but the transfer of two embryos results in a significantly higher MPR compared with single-embryo transfer. The majority of donor blastocyst cycles are noncompliant, which appears to be driving an unacceptably high MPR in these cycles.

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