{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:15:10Z","timestamp":1787004910347,"version":"build-2736575974"},"reference-count":33,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"06","license":[{"start":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T00:00:00Z","timestamp":1652659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Objective\u2003It is known that the single embryo transfer (SET) is the best choice to reduce multiples and associated risks. The practice of cryopreserving all embryos for posterior transfer has been increasingly performed for in vitro fertilization (IVF) patients at the risk of ovarian hyperstimulation syndrome or preimplantation genetic testing for aneuploidy. However, its widespread practice is still controverse. The aim of this study was to evaluate how effective is the transfer of two sequential SET procedures compared with a double embryo transfer (DET) in freeze-only cycles.<\/jats:p>\n                  <jats:p>Methods\u2003This retrospective study reviewed 5,156 IVF cycles performed between 2011 and 2019, and 506 cycles using own oocytes and freeze-only policy with subsequent elective frozen-thawed embryo transfers (eFET) were selected for this study. Cycles having elective SET (eSET, n\u2009=\u2009209) comprised our study group and as control group we included cycles performed with elective DET (eDET, n\u2009=\u2009291). In the eSET group, 57 couples who had failed in the 1st eSET had a 2nd eFET, and the estimated cumulative ongoing pregnancy rate was calculated and compared with eDET.<\/jats:p>\n                  <jats:p>Results\u2003After the 1st eFET, the ongoing pregnancy rates were similar between groups (eSET: 35.4% versus eDET: 38.5%; p\u2009=\u20090.497), but the estimated cumulative ongoing pregnancy rate after a 2nd eFET in the eSET group (eSET\u2009+\u2009SET) was significantly higher (48.8%) than in the eDET group (p\u2009&lt;\u20090.001). Additionally, the eSET\u2009+\u2009SET group had a 2.7% rate of multiple gestations, which is significantly lower than the eDET group, with a 30.4% rate (p\u2009&lt;\u20090.001).<\/jats:p>\n                  <jats:p>Conclusion\u2003Our study showed the association of freeze-only strategy with until up to two consecutive frozen-thawed eSETs resulted in higher success rates than a frozen-thawed DET, while drastically reducing the rate of multiple pregnancies.<\/jats:p>","DOI":"10.1055\/s-0042-1743096","type":"journal-article","created":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T19:11:11Z","timestamp":1652728271000},"page":"578-585","source":"Crossref","is-referenced-by-count":2,"title":["One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients"],"prefix":"10.61622","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9370-4300","authenticated-orcid":false,"given":"Pedro Felipe Magalh\u00e3es","family":"Peregrino","sequence":"additional","affiliation":[{"name":"Centro de Reprodu\u00e7\u00e3o Humana Monteleone, S\u00e3o Paulo, SP, Brazil"},{"name":"Centro de Reprodu\u00e7\u00e3o Humana \u201cGovernador Mario Covas\u201d, Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Cl\u00ednicas da Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5193-700X","authenticated-orcid":false,"given":"Tatiana Carvalho de Souza","family":"Bonetti","sequence":"additional","affiliation":[{"name":"Centro de Reprodu\u00e7\u00e3o Humana Monteleone, S\u00e3o Paulo, SP, Brazil"},{"name":"Molecular Gynecology Laboratory, Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"},{"name":"Centro de Neuroci\u00eancias e Sa\u00fade da Mulher \u201cProfessor Geraldo Rodrigues de Lima\u201d, Neuroscience Discipline of the Department of Neurology and Neurosurgery, Escola Paulista de Medicina - Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6228-5887","authenticated-orcid":false,"given":"Alecsandra Prado","family":"Gomes","sequence":"additional","affiliation":[{"name":"Centro de Reprodu\u00e7\u00e3o Humana Monteleone, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5389-2784","authenticated-orcid":false,"given":"Hamilton","family":"de Martin","sequence":"additional","affiliation":[{"name":"Centro de Reprodu\u00e7\u00e3o Humana Monteleone, S\u00e3o Paulo, SP, Brazil"},{"name":"Centro de Reprodu\u00e7\u00e3o Humana \u201cGovernador Mario Covas\u201d, Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Cl\u00ednicas da Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0774-9404","authenticated-orcid":false,"given":"Jos\u00e9 Maria","family":"Soares J\u00fanior","sequence":"additional","affiliation":[{"name":"Centro de Reprodu\u00e7\u00e3o Humana \u201cGovernador Mario Covas\u201d, Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Cl\u00ednicas da Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0111-9030","authenticated-orcid":false,"given":"Edmund Chada","family":"Baracat","sequence":"additional","affiliation":[{"name":"Centro de Reprodu\u00e7\u00e3o Humana \u201cGovernador Mario Covas\u201d, Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Cl\u00ednicas da Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0570-5969","authenticated-orcid":false,"given":"Pedro Augusto Ara\u00fajo","family":"Monteleone","sequence":"additional","affiliation":[{"name":"Centro de Reprodu\u00e7\u00e3o Humana Monteleone, S\u00e3o Paulo, SP, Brazil"},{"name":"Centro de Reprodu\u00e7\u00e3o Humana \u201cGovernador Mario Covas\u201d, Discipline of Gynecology, Department of Obstetrics and Gynecology, Hospital das Cl\u00ednicas da Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"47794","published-online":{"date-parts":[[2022,5,16]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1093\/humrep\/deq003","article-title":"Trends in delivery and neonatal outcome after in vitro fertilization in Sweden: data for 25 years","volume":"25","author":"B K\u00e4ll\u00e9n","year":"2010","journal-title":"Hum Reprod"},{"issue":"04","key":"ref2","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1016\/j.fertnstert.2011.11.050","article-title":"Elective single-embryo transfer","volume":"97","author":"Practice Committee of Society for Assisted Reproductive Technology","year":"2012","journal-title":"Fertil Steril"},{"issue":"06","key":"ref3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss6606a1","article-title":"Assisted Reproductive Technology Surveillance - United States, 2014","volume":"66","author":"S Sunderam","year":"2017","journal-title":"MMWR Surveill Summ"},{"issue":"05","key":"ref4","doi-asserted-by":"publisher","first-page":"676.e1","DOI":"10.1016\/j.ajog.2015.02.005","article-title":"Application of a validated prediction model for in vitro fertilization: comparison of live birth rates and multiple birth rates with 1 embryo transferred over 2 cycles vs 2 embryos in 1 cycle","volume":"212","author":"B Luke","year":"2015","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref5","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1016\/j.fertnstert.2017.02.107","article-title":"Guidance on the limits to the number of embryos to transfer: a committee opinion","volume":"107","author":"Practice Committee of the American Society for Reproductive Medicine","year":"2017","journal-title":"Fertil Steril"},{"issue":"02","key":"ref6","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.fertnstert.2016.06.001","article-title":"Fresh versus frozen: initial transfer or cumulative cycle results: how do we interpret results and design studies?","volume":"106","author":"M I Cedars","year":"2016","journal-title":"Fertil Steril"},{"issue":"01","key":"ref7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.fertnstert.2014.04.018","article-title":"Clinical rationale for cryopreservation of entire embryo cohorts in lieu of fresh transfer","volume":"102","author":"B S Shapiro","year":"2014","journal-title":"Fertil Steril"},{"issue":"05","key":"ref8","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1097\/OGX.0000000000000432","article-title":"Gonadotropin-releasing hormone-agonist triggering and a freeze-all approach: the final step in eliminating ovarian hyperstimulation syndrome?","volume":"72","author":"M J Davenport","year":"2017","journal-title":"Obstet Gynecol Surv"},{"issue":"11","key":"ref9","doi-asserted-by":"publisher","first-page":"1992","DOI":"10.1093\/humrep\/dey291","article-title":"Associations of blastocyst features, trophectoderm biopsy and other laboratory practice with post-warming behavior and implantation","volume":"33","author":"D Cimadomo","year":"2018","journal-title":"Hum Reprod"},{"issue":"02","key":"ref10","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.fertnstert.2011.05.050","article-title":"Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen-thawed embryo transfer in normal responders","volume":"96","author":"B S Shapiro","year":"2011","journal-title":"Fertil Steril"},{"issue":"06","key":"ref11","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1056\/NEJMoa1513873","article-title":"Fresh versus frozen embryos for infertility in the polycystic ovary syndrome","volume":"375","author":"Z J Chen","year":"2016","journal-title":"N Engl J Med"},{"issue":"08","key":"ref12","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1093\/humrep\/dey218","article-title":"The \u2018Big Freeze\u2019: freeze-all should not be used for everyone","volume":"33","author":"M Roque","year":"2018","journal-title":"Hum Reprod"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/0140-6736(92)92425-f","article-title":"Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte","volume":"340","author":"G Palermo","year":"1992","journal-title":"Lancet"},{"key":"ref14","volume-title":"An atlas of human gametes and conceptuses: an illustrated reference for assisted reproductive technology","author":"L L Veeck","year":"1999"},{"issue":"06","key":"ref15","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1016\/s0015-0282(00)00518-5","article-title":"Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer","volume":"73","author":"D K Gardner","year":"2000","journal-title":"Fertil Steril"},{"issue":"04","key":"ref16","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1016\/j.fertnstert.2020.09.003","article-title":"Why are multiple pregnancy rates and single embryo transfer rates so different globally, and what do we do about it?","volume":"114","author":"G D Adamson","year":"2020","journal-title":"Fertil Steril"},{"issue":"23","key":"ref17","doi-asserted-by":"publisher","first-page":"2392","DOI":"10.1056\/NEJMoa041032","article-title":"Elective single-embryo transfer versus double-embryo transfer in in vitro fertilization","volume":"351","author":"A Thurin","year":"2004","journal-title":"N Engl J Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.ejogrb.2014.04.009","article-title":"Randomised clinical trial comparing elective single-embryo transfer followed by single-embryo cryotransfer versus double embryo transfer","volume":"178","author":"M L L\u00f3pez-Regalado","year":"2014","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"02","key":"ref19","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.gyobfe.2007.12.004","article-title":"[Prospective evaluation of elective single-embryo transfer versus double-embryo transfer following in vitro fertilization: a two-year French hospital experience]","volume":"36","author":"L Leniaud","year":"2008","journal-title":"Gyn\u00e9col Obst\u00e9t Fertil"},{"issue":"02","key":"ref20","doi-asserted-by":"publisher","first-page":"133","DOI":"10.3109\/19396368.2015.1128991","article-title":"Clinical outcomes of frozen-thawed single blastocyst transfer in patients requiring whole embryo freezing","volume":"62","author":"Q H He","year":"2016","journal-title":"Syst Biol Reprod Med"},{"issue":"05","key":"ref21","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1111\/jog.13597","article-title":"Infertility treatment strategy involving combined freeze-all embryos and single vitrified-warmed embryo transfer during hormonal replacement cycle for in vitro fertilization of women with hypogonadotropic hypogonadism","volume":"44","author":"K Kuroda","year":"2018","journal-title":"J Obstet Gynaecol Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"E146","DOI":"10.1016\/j.fertnstert.2019.07.502","article-title":"The continued push towards eliminating twin pregnancy: the clinical impact of the 2017 ASRM embryo transfer guidelines","volume":"112","author":"A A Eubanks","year":"2019","journal-title":"Fertil Steril"},{"issue":"06","key":"ref23","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1007\/s00404-016-4196-5","article-title":"Novel embryo selection techniques to increase embryo implantation in IVF attempts","volume":"294","author":"G\u0391 Sigalos","year":"2016","journal-title":"Arch Gynecol Obstet"},{"issue":"04","key":"ref24","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1016\/j.fertnstert.2019.02.011","article-title":"Clinical approach to recurrent implantation failure: evidence-based evaluation of the endometrium","volume":"111","author":"H J Kliman","year":"2019","journal-title":"Fertil Steril"},{"issue":"11","key":"ref25","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.1007\/s10815-016-0773-6","article-title":"What is the contribution of embryo-endometrial asynchrony to implantation failure?","volume":"33","author":"W T Teh","year":"2016","journal-title":"J Assist Reprod Genet"},{"issue":"07","key":"ref26","doi-asserted-by":"publisher","first-page":"a022996","DOI":"10.1101\/cshperspect.a022996","article-title":"Human endometrial transcriptomics: implications for embryonic implantation","volume":"5","author":"E G\u00f3mez","year":"2015","journal-title":"Cold Spring Harb Perspect Med"},{"issue":"09","key":"ref27","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1093\/humrep\/deu171","article-title":"Deciphering the proteomic signature of human endometrial receptivity","volume":"29","author":"T Garrido-G\u00f3mez","year":"2014","journal-title":"Hum Reprod"},{"issue":"01","key":"ref28","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1002\/rmb2.12249","article-title":"Deciphering the effect of reproductive tract microbiota on human reproduction","volume":"18","author":"I Moreno","year":"2018","journal-title":"Reprod Med Biol"},{"issue":"07","key":"ref29","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1007\/s10815-018-1190-9","article-title":"Does the endometrial receptivity array really provide personalized embryo transfer?","volume":"35","author":"R Bassil","year":"2018","journal-title":"J Assist Reprod Genet"},{"issue":"02","key":"ref30","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1093\/humupd\/dmw038","article-title":"Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance","volume":"23","author":"L Rienzi","year":"2017","journal-title":"Hum Reprod Update"},{"issue":"01","key":"ref31","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s10815-017-1040-1","article-title":"Comparison of pregnancy outcomes after vitrification at the cleavage and blastocyst stage: a meta-analysis","volume":"35","author":"M Zeng","year":"2018","journal-title":"J Assist Reprod Genet"},{"issue":"05","key":"ref32","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1093\/humrep\/dey044","article-title":"Live birth rates in the first complete IVF cycle among 20 687 women using a freeze-all strategy","volume":"33","author":"Q Zhu","year":"2018","journal-title":"Hum Reprod"},{"issue":"04","key":"ref33","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1016\/j.fertnstert.2020.07.022","article-title":"Strategies to reduce multiple pregnancies during medically assisted reproduction","volume":"114","author":"C Bergh","year":"2020","journal-title":"Fertil Steril"}],"container-title":["Revista Brasileira de Ginecologia e Obstetr\u00edcia \/ RBGO Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journalrbgo.org\/article\/one-plus-one-is-better-than-two-an-approach-towards-a-single-blastocyst-transfer-policy-for-all-ivf-patients\/","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1743096.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T16:54:57Z","timestamp":1721321697000},"score":1,"resource":{"primary":{"URL":"https:\/\/journalrbgo.org\/article\/one-plus-one-is-better-than-two-an-approach-towards-a-single-blastocyst-transfer-policy-for-all-ivf-patients\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,16]]},"references-count":33,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2022,7,12]]},"published-print":{"date-parts":[[2022,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1743096","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0100-7203","1806-9339"],"issn-type":[{"value":"0100-7203","type":"print"},{"value":"1806-9339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,16]]}}}