Cleavage-stage or blastocyst transfer: what are the benefits and harms?

Fertil Steril. 2016 Aug;106(2):244-50. doi: 10.1016/j.fertnstert.2016.06.029. Epub 2016 Jul 13.

Abstract

ET is a critical step in an assisted reproduction cycle. Over the past decade there has been an increasing trend to extending culture from cleavage-stage to blastocyst transfer. There has also been a trend to single ET and reporting the success of an assisted reproductive cycle as a cumulative live-birth rate after using both fresh and frozen embryos. There is low evidence that fresh blastocyst transfer is associated with improved live-birth rates compared with fresh cleavage-stage embryos. However, in the few studies that report cumulative pregnancy rates after fresh and frozen transfers, no significant difference was found. Cleavage-stage transfer is associated with greater numbers of embryos available for freezing, and blastocyst transfer is associated with increased number of cycles with no embryos to transfer. Further well-designed studies are warranted to evaluate the outcomes for blastocyst transfer including cumulative live-birth rate after fresh and frozen transfers, time to live birth, costs of the different transfer strategies, and perinatal mortality and severe perinatal morbidity.

Keywords: Embryo transfer; blastocyst; cleavage.

Publication types

  • Review

MeSH terms

  • Blastocyst* / pathology
  • Chi-Square Distribution
  • Cleavage Stage, Ovum* / pathology
  • Cost-Benefit Analysis
  • Cryopreservation
  • Embryo Culture Techniques
  • Embryo Implantation*
  • Embryo Transfer / adverse effects
  • Embryo Transfer / economics
  • Embryo Transfer / methods*
  • Female
  • Fertility
  • Fertilization in Vitro / adverse effects
  • Fertilization in Vitro / economics
  • Health Care Costs
  • Humans
  • Infertility / diagnosis
  • Infertility / economics
  • Infertility / physiopathology
  • Infertility / therapy*
  • Live Birth
  • Odds Ratio
  • Pregnancy
  • Pregnancy Rate
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome