The impact of number of metaphase II oocytes and patient age on the multiple pregnancy rate in a gamete intrafallopian transfer (GIFT) programme
The original publication is available at http://www.samj.org.za
Objective. To study the effect of number of oocytes transferred and patient age on gamete intrafallopian transfer (GIFT) pregnancy and multiple pregnancy rates. Patients. GIFT patients from our clinical database were retrospectively analysed. They were divided into two age groups, under 38 years old and 38 and older. The patients were further divided into two subgroups, 3 oocytes and 4 or more oocytes transferred. Pregnancy rates and multiple pregnancy rates were calculated for the two groups. Statistical methods. The under-38 group's subgroups were nominated as group 1 (3 oocytes) and group 2 (s4 oocytes) and the 38-and-over group's subgroups as group A (3 oocytes) and group B (s4 oocytes). The x2 test and Fisher's exact test were used to analyse the data. Results. The ongoing pregnancy rate in group 1 was 28.8% (150/521) as opposed to 20.6% (96/465) in group 2 (P < 0.0045). The multiple pregnancy rate in group 1 was 14.0% (21/150) as opposed to 33.3% (32/96) in group 2 (P < 0.005). The triplet or higher-order pregnancy rate in group 1 was 2.7% (4/150) as opposed to 8.3% (8/96) in group 2 (not statistically significant). The ongoing pregnancy rate in group A was 11.8% (16/136) as opposed to 11.0% (8/73) in group B (NS). The multiple pregnancy rate in group A was 12.5% (2.16) as opposed to 25.0% (2/8) in group B (NS). Conclusions. These data show that transfer of more than 3 oocytes does not produce better pregnancy rates in either the under-38 or the 38-and-over group. The multiple pregnancy rate is, however, significantly higher when 4 or more oocytes are transferred in a GIFT programme. Transfer of more than 3 oocytes should therefore be restricted to carefully selected patients.
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