Day 3 Trasfer Program in In Vitro Fertilization and Embryo Transfer

Moon, Shin Yong; Choi, Young Min; Kim, Seok Hyun; Oh, Sun Kyung; Suh, Chang Suk; Lee, Jin Yong; Jung, Byeong Jun; Kim, Hee Sun; Ryu, Buom Yong; Kim, Jung Gu; Jee, Byung Chul; Oh, Soo Young

Abstract

OBJECTIVE
To investigate the positive or negative effect of delaying embryo transfer(ET) one day in IVF-ET.
METHODS
From May to July, 1997, a total of 64 patients was emolled in this prospective randomized case-controlled study. When the timing of oocyte retrieval was decided, random allocation of patients was made to one of the two groups: day 2 transfer or day 3 transfer. In day 3 transfer group, embryos were cultured in M3 media(Medi-Cult) for further 24 hours.
RESULTS
There were no significant differences in age of patients, infertility factor, basal serum FSH level, and serum E2 level on hCG day between two poups, but number of previous IVF-ET cycles was significantly higher in day 3 transfer group(p 0.042). Number of oocytes retrieved, fertilization rate, cleavage rate, and number of embryos transferred had no significant difference, but cumulative embryo score(CES) was significantly higher in day 3 transfer group(p 0.0001). Clinical pregnancy and implantation rates were bigher in day 3 transfer group, but without significance(34.4% vs. 21.9%; 8.7% vs, 5.4%). There were also no significant differences in spontaneous miscarriage and multiple pregnancy rates. Especially in patients over 35 years of age, clinical pregnancy and implantation rates were more higher in day 3 transfer group, but without significance(41.7% vs, 8.3%; 8.5% vs. 1.6%).
CONCLUSION
Considering the higher number of previous cycles in day 3 transfer group, it is at least likely that delaying ET one day may be clinically beneficial in IVF-ET, especially in patients with old age or repeated failure of previous cycles.