Factors that Influence The Occurrence of Multiple Pregnancies after Intracytoplasmic Injection Cycles with Two or Three Fresh Embryo Transfers

Background One of the important complications of assisted reproductive technologies is multiple pregnancy, the aim of the present study was to indentify the risk factors of multiple pregnancy independent of number of transfred embryos. MaterialsAndMethods This retrospective study reviewed the medical records of patients underwent intracytoplasmic sperm injection (ICSI) cycle in Royan Institute was between October 2011 and January 2012. Twelve factors affecting the number of gestational sac were entered in the Poisson regression (PR) model in two study population (cycles with double embryos transfer (DET) and cycles with three embryos transfer (TET), for determining the influencing factors on number of gestational sacs. Also this factors were entered in logistic regression (LR) for identifying the risk factors for multiple pregnancy. Results One thousand patients referred to Royan Institute for ART during the study period. A total of 606 eligible patients included in this study. The PR analysis demonstrated that the quality of transferred embryos and woman age have a significant effect on number of observed sac in patients underwent ICSI cyles with DET; However, based on the MLR analysis, no significant predictive variable for multiple preganacy in these patients was found. Our findings demonstrated that both regression models (PR and LR) have same outputs; the women age and fertilization rate were significant related variable with multiple pregnancy in patients underwent ICSI with TET. Conclusion It is suggested that for prevention of multiple pregnancies in women younger than 35 years old underwent ICSI cycles with high fertilization rate and obtained embryos with excellent or good quality, the single embryo transfer (SET) policy shoud be considered and the remaining embryos be cryopreserved. However, further prospective studies are necessary to evaluate whether SET in women with these risk factors would significantly decrease the multiple pregnancy rate and improve the cycle outcomes.