High multiple pregnancy rates after double embryo transfers in human: a retrospective cohort study

To improve clinical outcomes of human medically assisted reproduction, the transfer of multiple embryos is frequently performed. This leads to high rates of multiple pregnancies. In this study we explored if a cohort of patients can be defined, that benefits from the transfer of two embryos while mi...

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Main Authors: Jens Erik Dietrich, Ingrid Cáceres Valcárcel, Edison Capp, Thomas Strowitzki, Ariane Germeyer
Format: Article
Language:English
Published: Bioscientifica 2025-04-01
Series:Reproduction and Fertility
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Online Access:https://raf.bioscientifica.com/view/journals/raf/6/2/RAF-24-0078.xml
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author Jens Erik Dietrich
Ingrid Cáceres Valcárcel
Edison Capp
Thomas Strowitzki
Ariane Germeyer
author_facet Jens Erik Dietrich
Ingrid Cáceres Valcárcel
Edison Capp
Thomas Strowitzki
Ariane Germeyer
author_sort Jens Erik Dietrich
collection DOAJ
description To improve clinical outcomes of human medically assisted reproduction, the transfer of multiple embryos is frequently performed. This leads to high rates of multiple pregnancies. In this study we explored if a cohort of patients can be defined, that benefits from the transfer of two embryos while mitigating the odds of multiple pregnancies by considering female patients’ age, embryo quality and embryo cohort quality. In this retrospective cohort study, clinical pregnancy rate (CPR), live birth rate (LBR) and multiple pregnancy rate (MPR) after fresh single embryo transfers (SETs, n = 245) were compared to those after double embryo transfer (DET, n = 278). Female patient’s age, embryo quality and embryo cohort quality were used to explore clinical outcomes in subgroups. Overall, this study found that compared to SET, DET significantly increased the CPR (33.5 vs 49.6%, adjusted odds ratio (aOR): 2.233, 95% CI: 1.529–3.261, P < 0.001), LBR (24.1 vs 39.2%, aOR: 2.416, 1.605–3.636, P < 0.001) and MPR (0.0 vs 25.4%, P < 0.001). Subgroup analysis based on female age, embryo quality and further stratification based on embryo cohort score revealed that the MPR in all subgroups was high after DET and a subgroup with significantly reduced MPR after DET could not be defined. In conclusion, DETs are associated with high MPRs that cannot be avoided by considering female patients’ age, embryo quality and embryo cohort quality. SET is the most effective way to avoid a multiple pregnancy.
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spelling doaj-art-31aa6592c1574afeb17bcc4cebd35e2b2025-08-20T02:26:26ZengBioscientificaReproduction and Fertility2633-83862025-04-016210.1530/RAF-24-00781High multiple pregnancy rates after double embryo transfers in human: a retrospective cohort studyJens Erik Dietrich0Ingrid Cáceres Valcárcel1Edison Capp2Thomas Strowitzki3Ariane Germeyer4Heidelberg University Women´s Hospital, Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg, GermanyHeidelberg University Women´s Hospital, Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg, GermanyHeidelberg University Women´s Hospital, Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg, GermanyHeidelberg University Women´s Hospital, Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg, GermanyHeidelberg University Women´s Hospital, Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg, GermanyTo improve clinical outcomes of human medically assisted reproduction, the transfer of multiple embryos is frequently performed. This leads to high rates of multiple pregnancies. In this study we explored if a cohort of patients can be defined, that benefits from the transfer of two embryos while mitigating the odds of multiple pregnancies by considering female patients’ age, embryo quality and embryo cohort quality. In this retrospective cohort study, clinical pregnancy rate (CPR), live birth rate (LBR) and multiple pregnancy rate (MPR) after fresh single embryo transfers (SETs, n = 245) were compared to those after double embryo transfer (DET, n = 278). Female patient’s age, embryo quality and embryo cohort quality were used to explore clinical outcomes in subgroups. Overall, this study found that compared to SET, DET significantly increased the CPR (33.5 vs 49.6%, adjusted odds ratio (aOR): 2.233, 95% CI: 1.529–3.261, P < 0.001), LBR (24.1 vs 39.2%, aOR: 2.416, 1.605–3.636, P < 0.001) and MPR (0.0 vs 25.4%, P < 0.001). Subgroup analysis based on female age, embryo quality and further stratification based on embryo cohort score revealed that the MPR in all subgroups was high after DET and a subgroup with significantly reduced MPR after DET could not be defined. In conclusion, DETs are associated with high MPRs that cannot be avoided by considering female patients’ age, embryo quality and embryo cohort quality. SET is the most effective way to avoid a multiple pregnancy.https://raf.bioscientifica.com/view/journals/raf/6/2/RAF-24-0078.xmlembryo transfermultiple pregnancy ratelive birth ratefemale ageembryo quality
spellingShingle Jens Erik Dietrich
Ingrid Cáceres Valcárcel
Edison Capp
Thomas Strowitzki
Ariane Germeyer
High multiple pregnancy rates after double embryo transfers in human: a retrospective cohort study
Reproduction and Fertility
embryo transfer
multiple pregnancy rate
live birth rate
female age
embryo quality
title High multiple pregnancy rates after double embryo transfers in human: a retrospective cohort study
title_full High multiple pregnancy rates after double embryo transfers in human: a retrospective cohort study
title_fullStr High multiple pregnancy rates after double embryo transfers in human: a retrospective cohort study
title_full_unstemmed High multiple pregnancy rates after double embryo transfers in human: a retrospective cohort study
title_short High multiple pregnancy rates after double embryo transfers in human: a retrospective cohort study
title_sort high multiple pregnancy rates after double embryo transfers in human a retrospective cohort study
topic embryo transfer
multiple pregnancy rate
live birth rate
female age
embryo quality
url https://raf.bioscientifica.com/view/journals/raf/6/2/RAF-24-0078.xml
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