Effect Of Transferring An Additional Poor Embryo On Clinical Outcome Of In Vitro Fertilization Cycles

Objective: To compare the pregnancy outcomes of single good quality or poor quality embryo transfer and double poor quality embryo transfer in vitro fertilization,and evaluate the impact of double transfers of one poor quality embryo on the clinical outcomes of the in vitro fertilization cycles.Methods: Retrospective analysis of 2095 embryo transfer cycles completed at the reproductive center of our hospital from January 2017 to December 2021.Patients were divided into fresh embryo transfer group and frozen embryo transfer group based on the type of cycle.Patients were then divided into four groups based on the number and quality of transferred embryos: Group P: transplant a poor quality embryo;PP group:Two poor quality embryos were transplanted;Group G: Transfer a good quality embryo;GP group: Transfer one good quality embryo and one poor quality embryo.Results: During the fresh embryo transfer cycles,the pregnancy rate(36.2% vs 17.4%)and live birth rate(31.2%vs 15.7%)in Group fresh-G were higher than those in Group fresh-P.There was no significant difference in multiple birth rate(P>0.05);The pregnancy rate(30.0% vs 17.4%)and multiple pregnancy rate(19.9% vs 0.0%)of the fresh-PP group were higher than those of the fresh-P group,but there was no significant difference in live birth rate(22.0% vs 15.7%,P>0.05).The pregnancy rate(51.6% vs 36.2%),multiple pregnancy rate(22.5% vs 0.0%),and live birth rate(41.6% vs 31.2%)of the fresh-GP group were higher than those of the fresh-G group,and there was a significant difference(P<0.05).There was no significant difference in ectopic pregnancy rate,miscarriage rate,and premature birth rate among the four groups(P>0.05).During the frozen embryo transfer cycles,the pregnancy rate(42.3% vs 21.4%)and live birth rate(38.9% vs 19.0%)in Group frozen-G were higher than those in Group frozen-P,and there was no significant difference in multiple pregnancy rate(P>0.05);There was no significant difference in pregnancy rate(29.2% vs 21.4%),multiple pregnancy rate(11.5% vs 0.0%),and live birth rate(24.7% vs 19.0%)between the frozen-PP and frozen-P groups(P>0.05);There was no significant difference in pregnancy rate(45.6% vs 42.3%)and live birth rate(40.3% vs38.9%)between the frozen-GP and frozen-G groups(P>0.05),but the multiple pregnancy rate in the frozen-GP group was significantly higher than that in the frozen-G group(21.5% vs2.0%,P<0.05);There was no significant difference in ectopic pregnancy rate,miscarriage rate,and premature birth rate among the four groups(P>0.05).Conclusion: For patients without or with only one good quality embryo,the addition of one poor quality embryo for transfer does not significantly improve clinical pregnancy rate and live birth rate.Instead,it increases the rate of multiple pregnancies.