Breaking Free from SET: Revisiting the Paradigm with Euploid DET
In the ever-evolving landscape of assisted reproductive technology, a study at a single academic center seeks to challenge the existing norms. The spotlight is on euploid double embryo transfer (DET) as an alternative for patients with a history of at least one failed single embryo transfer (SET).
Riding the Wave: A Retrospective Journey into Euploid DET Cycles
The researchers embark on a retrospective chart review spanning from January 2019 to February 2023. Examining 40 embryo transfers, including 2 euploid blastocysts or a combination of 1 euploid and 1 mosaic blastocyst, they aim to unravel the potential benefits and risks associated with this unconventional approach.
Beyond Numbers: Understanding the Patients Behind Euploid DET
Of the 36 euploid DET cycles analyzed, 75% had a history of at least 2 failed embryo transfers. The mean patient age stands at 37.2 years, setting the stage for a diverse yet representative patient cohort.
Navigating Outcomes: CPR, Twin Rates, and the National Landscape
The primary outcomes under scrutiny are the clinical pregnancy rate (CPR) and clinical twin pregnancy rate following euploid DET. A comparative analysis with the SART National Summary Report for 2021 sheds light on how this unconventional approach stacks up against national standards.
Beyond Expectations: The Unsettling Reality of Twin Pregnancies
As the data unfolds, a surprising revelation surfaces. While the overall CPR after euploid DET stands at 41.7%, the clinical twin pregnancy rate spikes to 22.2%, with no higher-order multiples observed. This highlights a considerable risk of twin pregnancies, a factor that cannot be overlooked given its significant morbidity.
Benchmarking Reality: How Does Euploid DET Fare Nationally?
A comparative analysis with national statistics reveals intriguing disparities. The national reported CPR after the second or later embryo transfer stands at 54.9%, overshadowing the euploid DET CPR. The study's clinical twin pregnancy rate surpasses the national overall twin live birth rate after the second or later embryo transfer (22.2% vs. 5.5%).
Balancing Act: The Delicate Decision Between Risk and Benefit
In drawing conclusions, the study cautions against embracing euploid DET as a treatment option to improve prognosis in patients with a history of at least one failed SET. The evident risk of twin pregnancies, coupled with the lack of clear benefits over traditional approaches, prompts a reevaluation of the current norms.
Questioning Conventions: Rethinking the Role of Euploid DET
In a bold move, this study challenges the status quo. With a considerable risk of twin pregnancies and no definitive evidence to recommend euploid DET, it calls for a reevaluation of treatment options for patients with a history of failed SETs. The findings have far-reaching implications, urging the fertility community to question conventions and navigate the delicate balance between risk and benefit.
References: Forman EJ, Hong KH, Ferry KM, Tao X, Taylor D, Levy B, Treff NR, Scott RT Jr. In vitro fertilization with single euploid blastocyst transfer: a randomized controlled trial. Fertil Steril. 2013 Jul;100(1):100-7.e1. https://doi.org/10.1016/j.fertnstert.2013.02.056
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