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Zygote intrafallopian tube transfer versus intrauterine cleavage or blastocyst stage transfer after intracytoplasmic sperm injection cycles in patients with repeated implantation failure: A prospective follow‐up study
Author(s) -
Shahrokh Tehraninejad Ensieh,
Azimi Nekoo Elham,
Ghaffari Firouzeh,
Hafezi Maryam,
Karimian Leila,
Arabipoor Arezoo
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12779
Subject(s) - blastocyst transfer , intracytoplasmic sperm injection , medicine , blastocyst , embryo transfer , miscarriage , gynecology , assisted reproductive technology , pregnancy rate , andrology , obstetrics , pregnancy , embryo , infertility , embryogenesis , biology , genetics , microbiology and biotechnology
Aim This study aimed to compare the outcomes between zygote intrafallopian transfer (ZIFT) with intrauterine day‐3 (cleavage stage) embryo transfer and intrauterine day‐5 (blastocyst stage) embryo transfer in patients undergoing intracytoplasmic sperm injection. Material and Methods This prospective study was performed at Royan Institute, Tehran, Iran, between January 2012 and January 2014. Two hundred fifty women with more than three unexplained implantation failures were divided non‐randomly into three groups according to embryonic age and methods used as follows: (i) intrauterine cleavage‐stage embryo transfer ( n = 100); (ii) intrauterine blastocyst‐stage embryo transfer ( n = 50); and (iii) ZIFT ( n = 100). Implantation, clinical pregnancy, miscarriage and live birth rates were our main outcomes. Results Patients' characteristics and ovarian response were comparable among the three groups. Implantation rate (56.1% vs 27.9%) was significantly higher in the blastocyst group as compared to the ZIFT group; however, clinical pregnancy rate (38% vs 23%) was not statistically significantly different between the two groups, but due to the significantly higher miscarriage rate (34.7% vs 5.3%) in the ZIFT group, the live birth rate was significantly higher in the blastocyst group ( P = 0.04). No significant differences were found between the cleavage‐stage and blastocyst‐stage groups in terms of implantation, clinical pregnancy, miscarriage and live birth rates. Conclusion We do not recommend the use of the ZIFT procedure for patients with repeated implantation failures. It seems that replication of cleavage‐ or blastocyst‐stage embryo transfer is more efficient and affordable.