A comparative study of pregnancy outcome of sequential versus day 3 versus only blastocyst (day 6) transfer at a single IVF center over one year

Background: The recent introduction of sequential media has refocused attention upon the role of human blastocyst in IVF. For optimisation of extended cycles, one needs to give importance to all the aspects of treatment cycle like the stimulation regimens, medium composition, endometrial quality and uterine receptivity. This study was done to know the pregnancy outcomes of Day 3 transfer vs Day3/Day 6 transfer vs only Day 6 transfer.Methods: It was a retrospective study in which 342 patients undergoing ICSI were included. 199 women underwent Day 3/Day 6 sequential transfers, 112 underwent only Day 3 transfer and only 30 women were given only Blastocyst i.e. day 6 transfer. Pregnancy outcomes of all the three groups were studied.Results: Sequential transfer was found to give maximum pregnancy rate and highest implantation rate. But it was also associated with highest number of multiple pregnancies.Conclusions: Sequential transfer is a very good efficacious approach in ART cycles if extended media are available as it gave maximum pregnancy rate and implantation rate. However it is associated with multiple pregnancies. Thus the ultimate goal is to have a single blastocyst transfer with better outcomes and lower multiple pregnancy rates