{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:16:55Z","timestamp":1780568215462,"version":"3.54.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T00:00:00Z","timestamp":1603929600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T00:00:00Z","timestamp":1603929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81801532"],"award-info":[{"award-number":["81801532"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81871211"],"award-info":[{"award-number":["81871211"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81502507"],"award-info":[{"award-number":["81502507"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple pregnancies are associated with significant complications and health risks for both mothers and infants. Single blastocyst transfer (SBT) is a logical and effective measure to reduce the incidence of multiple pregnancy with assisted reproductive technology (ART). Whether it is suitable for everyone undergoing SBT was inconclusive, in view of the consideration of embryo quality and patients\u2019 age. Therefore, this study\u00a0aimed to explore live birth rate (LBR) and neonatal outcomes of different quantities and qualities of blastocysts in patients stratified by age, using a cutoff of 35 years, who required whole embryo freezing and underwent a subsequent frozen thawed transfer (FET) cycle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Atotal of 3,362 patients were divided into five groups: group A (\n                      <jats:italic>n<\/jats:italic>\n                      =1569) received a single good-quality blastocyst, group B (\n                      <jats:italic>n<\/jats:italic>\n                      =1113) received two good-quality blastocysts, group C (\n                      <jats:italic>n<\/jats:italic>\n                      =313) received one good-and one average-quality blastocyst, group D (\n                      <jats:italic>n<\/jats:italic>\n                      =222) received two average-quality blastocysts, and group E (\n                      <jats:italic>n<\/jats:italic>\n                      =145) received one average-quality blastocyst.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For patients who received good-quality blastocysts, irrespective of age, the LBR of double blastocyst transfer (DBT) was about 50\u201365% and the multiple pregnancy rate (MPR) was 40\u201360%; however, the LBR of SBT was 40\u201355%, and the MPR was 3.5\u20136.3%. For patients who only\u00a0had\u00a0average-quality blastocysts, the MPR of double average-quality blastocyst transfer was as high as 30\u201350%. Moreover, about 70\u201390% of preterm births resulted from multiple pregnancies, and about 85\u201395% of low birth weight babies come from multiple pregnancies. The neonatal outcomes (gestational age, birth weight, and birth height) of DBT were significantly lower than those of SBT regardless of age, and this statistical difference disappeared if the patients were subgrouped by singleton or twin. There is no significant difference in neonatal outcomes between single good-quality blastocyst and single average-quality blastocyst transfer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SBT is a preferable option for patients regardless of age when good-quality blastocysts are available. For patients who only had average-quality blastocysts, they should be informed that DBT was associated with higher multiple pregnancy and adverse neonatal outcomes when compared with SBT regardless of age, suggesting that the practice of SBT is also feasible for these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-020-03353-5","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T09:03:09Z","timestamp":1603962189000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Live birth rate and neonatal outcomes of different quantities and qualities of frozen transferred blastocyst in patients requiring whole embryo freezing stratified by age"],"prefix":"10.1186","volume":"20","author":[{"given":"Shiping","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongzi","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianqiao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiying","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4470-6342","authenticated-orcid":false,"given":"Yuxia","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"issue":"8085","key":"3353_CR1","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/S0140-6736(78)92957-4","volume":"2","author":"PC Steptoe","year":"1978","unstructured":"Steptoe PC, Edwards RG. Birth after the reimplantation of a human embryo. Lancet. 1978;2(8085):366.","journal-title":"Lancet"},{"issue":"10","key":"3353_CR2","doi-asserted-by":"publisher","first-page":"2099","DOI":"10.1093\/humrep\/deu175","volume":"29","author":"MS Kupka","year":"2014","unstructured":"Kupka MS, et al. Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHRE. Hum Reprod. 2014;29(10):2099\u2013113.","journal-title":"Hum Reprod"},{"key":"3353_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40738-016-0024-7","volume":"2","author":"T Tobias","year":"2016","unstructured":"Tobias T, et al. Promoting the use of elective single embryo transfer in clinical practice. Fertil Res Pract. 2016;2:1.","journal-title":"Fertil Res Pract"},{"issue":"12","key":"3353_CR4","doi-asserted-by":"publisher","first-page":"3609","DOI":"10.1093\/humrep\/des315","volume":"27","author":"EA Sullivan","year":"2012","unstructured":"Sullivan EA, et al. Single embryo transfer reduces the risk of perinatal mortality, a population study. Hum Reprod. 2012;27(12):3609\u201315.","journal-title":"Hum Reprod"},{"key":"3353_CR5","unstructured":"Practice Committee of Society for Assisted Reproductive. T, Practice Committee of American Society for Reproductive M. Elective single-embryo transfer. Fertil Steril. 2012;97(4):835\u201342."},{"issue":"11","key":"3353_CR6","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1056\/NEJMoa053524","volume":"354","author":"EG Papanikolaou","year":"2006","unstructured":"Papanikolaou EG, et al. In vitro fertilization with single blastocyst-stage versus single cleavage-stage embryos. N Engl J Med. 2006;354(11):1139\u201346.","journal-title":"N Engl J Med"},{"issue":"3","key":"3353_CR7","doi-asserted-by":"publisher","first-page":"164","DOI":"10.5653\/cerm.2016.43.3.164","volume":"43","author":"JH Eum","year":"2016","unstructured":"Eum JH, et al. Clinical outcomes of single versus double blastocyst transfer in fresh and vitrified-warmed cycles. Clin Exp Reprod Med. 2016;43(3):164\u201368.","journal-title":"Clin Exp Reprod Med"},{"issue":"6","key":"3353_CR8","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1016\/j.fertnstert.2005.06.035","volume":"84","author":"A Criniti","year":"2005","unstructured":"Criniti A, et al. Elective single blastocyst transfer reduces twin rates without compromising pregnancy rates. Fertil Steril. 2005;84(6):1613\u20139.","journal-title":"Fertil Steril"},{"issue":"6","key":"3353_CR9","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1007\/s10815-017-0906-6","volume":"34","author":"S Tannus","year":"2017","unstructured":"Tannus S, Son WY, Dahan MH. Elective single blastocyst transfer in advanced maternal age. J Assist Reprod Genet. 2017;34(6):741\u20138.","journal-title":"J Assist Reprod Genet"},{"issue":"6","key":"3353_CR10","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/j.rbmo.2017.07.017","volume":"35","author":"S Tannus","year":"2017","unstructured":"Tannus S, et al. Cumulative live birth rate following elective single blastocyst transfer compared with double blastocyst transfer in women aged 40 years and over. Reprod Biomed Online. 2017;35(6):733\u20138. .","journal-title":"Reprod Biomed Online"},{"issue":"2","key":"3353_CR11","doi-asserted-by":"publisher","first-page":"133","DOI":"10.3109\/19396368.2015.1128991","volume":"62","author":"QH He","year":"2016","unstructured":"He QH, et al. Clinical outcomes of frozen-thawed single blastocyst transfer in patients requiring whole embryo freezing. Syst Biol Reprod Med. 2016;62(2):133\u20138.","journal-title":"Syst Biol Reprod Med"},{"issue":"1","key":"3353_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12958-019-0560-1","volume":"18","author":"Y He","year":"2020","unstructured":"He Y, et al. Delayed frozen embryo transfer failed to improve live birth rate and neonatal outcomes in patients requiring whole embryo freezing. Reprod Biol Endocrinol. 2020;18(1):1.","journal-title":"Reprod Biol Endocrinol"},{"issue":"6","key":"3353_CR13","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1016\/S0015-0282(00)00518-5","volume":"73","author":"DK Gardner","year":"2000","unstructured":"Gardner DK, et al. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000;73(6):1155\u20138.","journal-title":"Fertil Steril"},{"key":"3353_CR14","first-page":"1","volume":"undefined","author":"A Racca","year":"2020","unstructured":"Racca A, et al. Single and double embryo transfer provide similar live birth rates in frozen cycles. Gynecol Endocrinol. 2020;undefined:1\u20135.","journal-title":"Gynecol Endocrinol"},{"issue":"6","key":"3353_CR15","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1016\/j.fertnstert.2008.12.137","volume":"93","author":"CM Mullin","year":"2010","unstructured":"Mullin CM, et al. Comparison of pregnancy outcomes in elective single blastocyst transfer versus double blastocyst transfer stratified by age. Fertil Steril. 2010;93(6):1837\u201343.","journal-title":"Fertil Steril"},{"issue":"7","key":"3353_CR16","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1056\/NEJM198202183060712","volume":"306","author":"AH DeCherney","year":"1982","unstructured":"DeCherney AH, Berkowitz GS. Female fecundity and age. N Engl J Med. 1982;306(7):424\u20136.","journal-title":"N Engl J Med"},{"issue":"6","key":"3353_CR17","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1016\/j.fertnstert.2013.07.2002","volume":"100","author":"GL Harton","year":"2013","unstructured":"Harton GL, et al. Diminished effect of maternal age on implantation after preimplantation genetic diagnosis with array comparative genomic hybridization. Fertil Steril. 2013;100(6):1695\u2013703.","journal-title":"Fertil Steril"},{"issue":"2","key":"3353_CR18","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1007\/s10815-014-0387-9","volume":"32","author":"S Fern\u00e1ndez-Shaw","year":"2015","unstructured":"Fern\u00e1ndez-Shaw S, et al. Ongoing and cumulative pregnancy rate after cleavage-stage versus blastocyst-stage embryo transfer using vitrification for cryopreservation: impact of age on the results. J Assist Reprod Genet. 2015;32(2):177\u201384.","journal-title":"J Assist Reprod Genet"},{"issue":"8","key":"3353_CR19","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1111\/1471-0528.14368","volume":"124","author":"U Waldenstr\u00f6m","year":"2017","unstructured":"Waldenstr\u00f6m U, et al. Advanced maternal age increases the risk of very preterm birth, irrespective of parity: a population-based register study. BJOG. 2017;124(8):1235\u201344. .","journal-title":"BJOG"},{"issue":"4","key":"3353_CR20","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1016\/S0015-0282(01)03251-4","volume":"77","author":"BS Shapiro","year":"2002","unstructured":"Shapiro BS, et al. Influence of patient age on the growth and transfer of blastocyst-stage embryos. Fertil Steril. 2002;77(4):700\u20135.","journal-title":"Fertil Steril"},{"issue":"11","key":"3353_CR21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss6411a1","volume":"64","author":"S Sunderam","year":"2015","unstructured":"Sunderam S, et al. Assisted Reproductive Technology Surveillance-United States, 2013. MMWR Surveill Summ. 2015;64(11):1\u201325.","journal-title":"MMWR Surveill Summ"},{"issue":"4","key":"3353_CR22","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1016\/j.fertnstert.2017.02.107","volume":"107","author":"Practice Committee of the American Society for Reproductive Medicine","year":"2017","unstructured":"Practice Committee of the American Society for Reproductive Medicine. Electronic address Aao, Practice Committee of the Society for Assisted Reproductive T. Guidance on the limits to the number of embryos to transfer: a committee opinion. Fertil Steril. 2017;107(4):901\u20133.","journal-title":"Fertil Steril"},{"issue":"7","key":"3353_CR23","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1093\/humrep\/deu079","volume":"29","author":"G Oron","year":"2014","unstructured":"Oron G, et al. The association between embryo quality and perinatal outcome of singletons born after single embryo transfers: a pilot study. Hum Reprod. 2014;29(7):1444\u201351.","journal-title":"Hum Reprod"},{"issue":"12","key":"3353_CR24","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1007\/s10815-014-0351-8","volume":"31","author":"J Zhu","year":"2014","unstructured":"Zhu J, et al. Does IVF cleavage stage embryo quality affect pregnancy complications and neonatal outcomes in singleton gestations after double embryo transfers? J Assist Reprod Genet. 2014;31(12):1635\u201341. .","journal-title":"J Assist Reprod Genet"},{"issue":"2","key":"3353_CR25","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1093\/humrep\/dez287","volume":"35","author":"J Zhang","year":"2020","unstructured":"Zhang J, et al. The impact of embryo quality on singleton birthweight in vitrified-thawed single blastocyst transfer cycles. Hum Reprod. 2020;35(2):308\u201316.","journal-title":"Hum Reprod"},{"key":"3353_CR26","doi-asserted-by":"crossref","unstructured":"He YX, et al. Clinical outcomes of different quantity and quality of frozen blastocyst transfer in patients requiring whole embryo freezing stratified by age. IFFS 2019: International Federation of Fertility Societies Shanghai World Congress; 2019 Apr 11\u201315; Shanghai, China. Global Reprod Health: p e30. \n                  https:\/\/journals.lww.com\/grh\/Fulltext\/2019\/03000\/Meeting_Abstracts_from_the_2019_IFFS_Shanghai.4.aspx\n                  \n                .","DOI":"10.1097\/GRH.0000000000000030"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-020-03353-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12884-020-03353-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-020-03353-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T11:05:46Z","timestamp":1604228746000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-020-03353-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,29]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["3353"],"URL":"https:\/\/doi.org\/10.1186\/s12884-020-03353-5","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-44754\/v3","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-44754\/v4","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-44754\/v1","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.3.rs-44754\/v2","asserted-by":"object"}]},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,29]]},"assertion":[{"value":"16 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 October 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the ethics committee of the Third Affiliated Hospital of Guangzhou Medical University. Since this is a retrospective investigation, patients were not asked to participate in this study. Each patient has signed an informed consent on obtaining and analyzing their clinical data prior to the initiation of IVF\/ICSI-ET treatment.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"655"}}