{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T09:36:23Z","timestamp":1793007383171,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":147,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Reprod Medicine &amp;amp; Biology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To develop a simulation model to guide single embryo transfer (SET) versus double embryo transfer (DET) decisions by minimizing twin risk per transfer while maintaining treatment efficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study included individuals undergoing SET or DET with frozen blastocysts in hormone replacement therapy. Three generalized estimating equation\u2010based models were developed: ongoing pregnancy after SET (Model 1) and DET (Model 2), and twin pregnancy after DET (Model 3). Model 1 was constructed using propensity score\u2010matched SETs comparable to DETs. The simulation aimed to identify the optimal transfer sequence for patients with multiple blastocysts using a stepwise optimization that selects SET or DET at each transfer while maximizing pregnancy probability and constraining twin risk below predefined thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      5721 DET and 5719 matched SET cycles were included in the analysis. The ongoing pregnancy rate was 20.1% in matched SET and 25.1% in DET, while the ongoing twin pregnancy rate following DET was 5.5%. Area under the curve was 0.77, 0.73, and 0.82 for Model 1\u20133, respectively. Simulation demonstrated an optimal sequence combining SET\/DET under the individualized twin risk in a variety of scenarios (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/sites.google.com\/view\/det-simulator\/%E3%83%9B%E3%83%BC%E3%83%A0\">https:\/\/sites.google.com\/view\/det\u2010simulator\/<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This model supports individualized embryo transfer planning by balancing treatment efficiency and twin risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/rmb2.70064","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:35:09Z","timestamp":1779953709000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transfer Strategy Minimizing Twin Risk of Double Blastocyst Transfers Based on Prediction Models"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2054-4684","authenticated-orcid":false,"given":"Kazuma","family":"Onishi","sequence":"first","affiliation":[{"name":"Asada Ladies Clinic  Nagoya Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1832-8405","authenticated-orcid":false,"given":"Daichi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Asada Ladies Clinic  Nagoya Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Kida","sequence":"additional","affiliation":[{"name":"Asada Institute for Reproductive Medicine  Kasugai Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masae","family":"Kojima","sequence":"additional","affiliation":[{"name":"Asada Institute for Reproductive Medicine  Kasugai Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noritaka","family":"Fukunaga","sequence":"additional","affiliation":[{"name":"Asada Institute for Reproductive Medicine  Kasugai Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimasa","family":"Asada","sequence":"additional","affiliation":[{"name":"Asada Ladies Clinic  Nagoya Aichi Japan"},{"name":"Asada Institute for Reproductive Medicine  Kasugai Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae010"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2021.06.050"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.04.011"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12958\u2010021\u201000734\u2010z"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815\u2010013\u20100039\u20105"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201090254\u2010y"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dez258"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckaf099"},{"key":"e_1_2_11_10_1","first-page":"378","volume-title":"Towards Reproductive Certainty: Fertility and Genetics Beyond","author":"Gardner D. 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