Experience with a patient-friendly, mandatory, single-blastocyst transfer policy: the power of one John M. Csokmay, M.D., Micah J. Hill, D.O., Rebecca.

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Experience with a patient-friendly, mandatory, single-blastocyst transfer policy: the power of one John M. Csokmay, M.D., Micah J. Hill, D.O., Rebecca J. Chason, M.D., Sasha Hennessy, B.S., Aidita N. James, Ph.D., Jacques Cohen, Ph.D., Alan H. DeCherney, M.D., James H. Segars, M.D., Mark D. Payson, M.D. Fertility and Sterility Volume 96, Issue 3, Pages 580-584 (September 2011) DOI: 10.1016/j.fertnstert.2011.06.043 Copyright © 2011 Terms and Conditions

Figure 1 Summary of the mandatory single-blastocyst transfer (mSBT) algorithm from study inclusion to embryo transfer. Patients <38 years old and undergoing their first assisted reproductive technology (ART) cycle were included in the analysis (Box 1). On day 3 after oocyte retrieval (Box 2), patients with at least four high-grade embryos were encouraged to proceed to a day-5 blastocyst transfer. If the patient agreed to the mSBT policy, the embryos were placed in extended culture. If the patient declined the mSBT policy, two cleavage-stage embryos were transferred on day 3. On day 5 after oocyte retrieval (Box 3), patients who agreed to the mSBT had a transfer of a single high-grade blastocyst. If the blastocyst was less than “BB” grade, the patient was given the option to transfer one or two blastocysts. Fertility and Sterility 2011 96, 580-584DOI: (10.1016/j.fertnstert.2011.06.043) Copyright © 2011 Terms and Conditions

Figure 2 (A) Summary of the percentage of blastocysts transferred per patient (y axis) over time per quarter year (Q1–4) from 2009 to 2010 (x axis). Transfers of a single blastocyst (red line) increased after the institution of the mandatory single-blastocyst transfer (mSBT) policy as marked with an arrow in January 2010. Conversely, the percentage of two blastocyst transfers (blue line) decreased after the mSBT policy. No patient had more than two blastocysts transferred, so the total percentage of embryos transferred each quarter equals 100%. (B) Percentage of patients accepting or declining a single-blastocyst transfer (x axis) in 2010 (quarters 1–4, y axis) as designated by their agreement or declination of the mandatory single-blastocyst (mSBT) policy. More patients agreed (red bars) to the mSBT as 2010 progressed and fewer patients declined (blue bars). Fertility and Sterility 2011 96, 580-584DOI: (10.1016/j.fertnstert.2011.06.043) Copyright © 2011 Terms and Conditions