{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:47:03Z","timestamp":1786978023448,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology & Obste"],"published-print":{"date-parts":[[2024,12]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To evaluate whether extending embryo culture to day 5 (D5) affects pregnancy rates in women older than 38\u2009years undergoing in\u00a0vitro fertilization (IVF).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective, observational cohort study included data from fresh IVF cycles of women over 38\u2009years, during 2011\u20132021. The cohort was divided according to day 3 (D3) versus D5 embryo transfer (ET).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 346 patients (ages 38\u201345\u2009years) who underwent 496 IVF cycles were included, each yielding one to six embryos. A total of 374 (75%) fresh D3 ETs were compared with 122 (25%) D5 ETs. Demographically, there were more nulliparas in the D3 group (189 [50.9%] vs 47 [38.8%],\n P<\/jats:italic>\n \u2009=\u20090.021). Higher gonadotropin dosage was used (3512\u2009\u00b1\u20091346 vs 3233\u2009\u00b1\u20091212\u2009IU,\n P<\/jats:italic>\n \u2009=\u20090.045) and lower maximum estradiol levels were reached in the D3 group (1129\u2009\u00b1\u2009685 vs 1432\u2009\u00b1\u2009708\u2009pg\/mL,\n P<\/jats:italic>\n \u2009=\u20090.002). Thirty\u2010three (27%) of the D5 cycles resulted in transfer cancelation due to failure of blastocyst formation (\n P<\/jats:italic>\n \u2009=\u20090.001). However, clinical pregnancy rates (\n P<\/jats:italic>\n \u2009=\u20090.958), live birth rates (\n P<\/jats:italic>\n \u2009=\u20090.988), and miscarriage rates (\n P<\/jats:italic>\n \u2009=\u20090.710) did not differ between D3 and D5 ETs. Multivariable logistic regression for clinical pregnancy rate showed that day of transfer did not have a significant effect on the odds (\n P<\/jats:italic>\n \u2009=\u20090.376), but maternal age (\n P<\/jats:italic>\n \u2009=\u20090.001) and number of retrieved oocytes (\n P<\/jats:italic>\n \u2009=\u20090.009) were significant variables.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In older women, culturing embryos to blastocyst stage can decrease invalid ETs without reducing pregnancy rates. Cancelation rates are higher but it may avoid interventions and conserve valuable time.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ijgo.15753","type":"journal-article","created":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T03:54:03Z","timestamp":1719719643000},"page":"1017-1022","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Does cleavage\u2010 versus blastocyst\u2010stage embryo transfer improve fertility rates in women over 38\u2009years of age undergoing assisted reproductive technology?"],"prefix":"10.1002","volume":"167","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0969-4445","authenticated-orcid":false,"given":"Eytan","family":"Giladi Yacobi","sequence":"first","affiliation":[{"name":"IVF and Fertility Institute, Tel\u2010Aviv Sourasky Medical Center Tel Aviv University Tel Aviv Israel"},{"name":"Faculty of Medical and Health Sciences, School of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Netanella","family":"Miller","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences, School of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"IVF Unit, Department of Obstetrics and Gynecology Meir Medical Center Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitzan Goren","family":"Gepstein","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences, School of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"IVF Unit, Department of Obstetrics and Gynecology Meir Medical Center Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordana","family":"Mashiach","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences, School of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"IVF Unit, Department of Obstetrics and Gynecology Meir Medical Center Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einat Haikin","family":"Herzberger","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences, School of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"IVF Unit, Department of Obstetrics and Gynecology Meir Medical Center Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattan","family":"Levi","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences, School of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"IVF Unit, Department of Obstetrics and Gynecology Meir Medical Center Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehudith","family":"Ghetler","sequence":"additional","affiliation":[{"name":"IVF Unit, Department of Obstetrics and Gynecology Meir Medical Center Kfar Saba 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