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.
Retrospective cohort study of United States national registry information.
Not applicable.
A total of 13,393 donor-recipient cycles from 2011 to 2012.
Embryos transferred in
donor IVF cycles.
Percentage of compliant cycles, multiple pregnancy rate.
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).
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.