Does transferring a good-quality embryo with a lower-quality embryo reduce the probability of success?
This is a question I am often asked by patients.
In the August 2020 edition of Fertility and Sterility, “Is transferring a lower-quality embryo with a good-quality blastocyst detrimental to the likelihood of live birth?” was published. This is a good study that indicates when transferring a lower quality blastocyst with a high-quality blastocyst, at the same time, it does not result in a decreased probability of success. In fact, there is a small increase in the number of live births. In women 38 years or older, the rate increased about 9% with regards to live birth and there was about a 15% increase in multiple pregnancy. For patients under 38 years old, the increase in the live birth rate was about 7% but there was an 18% increase in the multiple pregnancy rate.
With that said, the embryos were not tested with PGT-A in this study. At MCRM Fertility, we have increased the recommendation for the use of PGT-A and as a result, utilize single embryo transfer almost universally. So, the multiple pregnancy rate, thankfully, has tremendously decreased over time. The overall live birth rate and success rate has increased significantly, as well.