Pregnancy Rate in Double Embryo Transfer, Mixed Embryo Transfer and Blastocyst Transfer in Patients with a History of Recurrent Implantation Failure

Document Type : Original Article

Authors

1 Professor, Department of Obstetrics and Gynecology, Fellowship of Infertility and IVF, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

3 Assistant Professor, Department of Embryology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

4 Assistant Professor, Department of Computer Sciences, School of Mathematical Sciences, Shahrekord University, Shahrekord, Iran.

5 Medical Student, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

6 Associate Professor, Department of Obstetrics and Gynecology, Fellowship of Infertility and IVF, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

7 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

10.22038/ijogi.2025.80975.6132

Abstract

Introduction: Repeated implantation failure indicates the inability to achieve pregnancy despite the transfer of high-quality embryos. Some studies have shown a higher pregnancy rate with blastocyst, double, or mixed transfers than cleavage stage embryo transfers. The present study was conducted with aim to compare the pregnancy rates in these three transfer methods in patients with repeated implantation failure.
Methods: This retrospective cross sectional study was conducted in 2021-2023 on 150 patients with diagnosis of repeated implantation failure at shahid akbarabadi hospital affiliated with Iran University of Medical Sciences. All these cases had 3-days frozen embryos. After preparing the endometrium, in one group, blastocyst embryo, and in another group, 3days embryo and then blastocyst embryo (double transfer), and in the third group, 3-days and 5-days embryos were transferred. Demographic characteristics and pregnancy rate of the patients were analyzed using one-way analysis of variance, Kruskal-Wallis test and chi-square test. P<0.05 was considered statistically significant.
Results: There was higher chemical pregnancy in the blastocyst group (38.6%), then in double group (29.8%) and the mix group (19.4%). Higher clinical pregnancy was in the blastocyst group (26.3%), followed by the double group (17.5%) and the mixed group (11.1%); despite the higher pregnancy in the blastocyst transfer, no significant difference was observed among the groups (p=0.177). There were two cases of miscarriage in the blastocyst transfer and one case of heterotopic pregnancy in the double group.
Conclusion: The percentage of chemical and clinical pregnancy was higher in the blastocyst transfer group than the other two groups, but there was no statistically significant difference.

Keywords

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References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 7
September 2025
Pages 1-8

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