Determining the Human Blastocyst Transfer for Success Rate in Artificial Reproductive Technology (ART) Treatment

Abstract

All over the world, many of the ART centers, especially those without experience perform Cleavage stage and not blastocyst transfers. Although it has been proved without doubt that Blastocyst transfer is better, the personal experience of failure after shifting to Blastocyst transfer has demotivated many from the shift. The aim of this article is to explain to the reader how we at the University hospital took evidence based decisions and improved our culture conditions while increasing our pregnancy rates. Although the outcome of an ART cycle depends on a multitude of clinical and laboratory factors, this study pursued to critically explore the various advantages and disadvantages of changing the protocol in a German lab to international standards where blastocyst culture is the norm. 1126 ART cycles were performed from 2014 to 2018 in the University Reproductive Medical Unit of UKSH, Kiel. There was an improvement in pregnancy rates from 2014 to 2018 in both cleavage stage transfer (day 3) and blastocyst transfer with a 1.4 time increase every year. Improvement in the lab culture conditions had profound effect in increasing pregnancy rates. The article aims at encouraging the reader to make decisions to improve lab blastocyst culture conditions before shifting to blastocyst culture to improve pregnancy rates and not blindly shift overnight to blastocyst for all.