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Background: Multiple births after assisted reproduction techniques are associated with adverse outcome. Transferring one blastocyst is the best way to reduce the rate of multiple births but it may also decrease the clinical pregnancy rate if not used wisely. Methods: In this study we reviewed the records of 170 women who undergone transfer of 1–3 blastocysts on day 5 or day 6 after in vitro fertilization from 2008 to 2010 to explore the outcome of elective single blastocyst transfer (SBT) compared with multiple blastocyst embryo transfer (MBT) and determine how this affects multiple pregnancy rates. Results: The result suggested increasing the number of blastocysts transferred based on advanced age or poor blastocyst quality did not result in any significant increase in CPR while there was significant increase in multiple pregnancy rate (MPR). On the other hand, using the time of transfer as main criteria to decide the number of blastocysts transferred increased the CPR significantly, without significant increase in MPR. Conclusion: Our study identified blastocyst transfer time (in hours) could be the best criteria to transfer single blastocyst (SBT) versus double blastocyst (DBT), as that showed to maximize the clinical pregnancy rate with no increase in multiple pregnancy rate. The likelihood of pregnancy is significantly higher in the group of women who had 2 blastocysts transferred after 140 h compared to SBT, with no increase in the multiple pregnancy rate.

Data from 107 women undergoing their first IVF/ICSI were analyzed. Relationships between antimullerian hormone (AMH) and follicle stimulating hormone (FSH) were analyzed after dividing patients into four groups according to AMH/FSH levels. Concordance was noted in 57% of women (both AMH/FSH either normal or abnormal) while 43%of women had discordant values (AMH/FSH one hormone normal and the other abnormal). Group 1 (AMH and FSH in normal range) and group 2 (normal AMH and high FSH) were younger compared to group 3 (low AMH and normal FSH) and group 4 (both AMH/FSH abnormal). Group 1 showing the best oocyte yield was compared to the remaining three groups. Groups 3 and 4 required higher dose of gonadotrophins for controlled ovarian hyperstimulation showing their low ovarian reserve. There was no difference in cycle cancellation, clinical pregnancy, and live birth/ongoing pregnancy rate in all groups. These tests are useful to predict ovarian response but whether AMH is a substantially better predictor is not yet established.