Background: The
transfer of multiple embryos during ART procedures (IVF/ICSI) in order to
maximize the chance of pregnancy, has resulted in increasing rates of multiple
pregnancies with a 20- fold increased risk of twins and 400- fold increased
risk of higher order pregnancies with significantly high maternal and perinatal
morbidity and mortality in comparison with singleton. Since at present there is
no limitation in number of embryos being transferred in ART cycles in
infertility centers in Iran, in order to evaluate the relationship between
number of embryos transferred, pregnancy rates and multiple pregnancy, this
study was performed in a referral university center.
Methods: In a cross
sectional descriptive analytical study a total of 536 ART cycles in infertile
patients treated at the Infertility Department of Vali-e-Asr Hospital &
Vali-e-Asr Reproductive Health Research Center from October 1999- March 2003 were
evaluated using a questionnaire dealing with the parameters affecting ART
outcome.
Results: There was a
total pregnancy rate of 21% with a multiple pregnancy rate of 12%. Increased
age had a negative effect on pregnancy rate with a significant difference over 40
years (p<0.05). Pregnancy rate was higher with increased number of
transferred embryos but it was only statistically significant when three versus
two embryos were transferred (p<0.008). When more than three embryos
transferred, although there was an increase in pregnancy rate, the difference
was not statistically significant, but there was a significant increase in
multiple pregnancy rate.
Conclusions: The maximum number of transferred embryos in ART cycles should not precede three
embryos especially in age groups less than 40 and also when good quality
embryos are available.
