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To determine the relationship between blastocyst score and pregnancy outcome.

Retrospective review of blastocyst transfer in an IVF clinic.

Private assisted reproductive technology unit. Patient(s): 107 patients undergoing blastocyst culture and transfer of two embryos. Intervention(s): Culture of all pronucleate embryos in sequential media to the blastocyst stage (day 5), followed by transfer of two blastocysts. Main Outcome Measure(s): Implantation rates, pregnancy rates, and twinning were analyzed. Result(s): When a patient received two top-scoring blastocysts (64% of patients), implantation and pregnancy rates were 70% and 87%, respectively. The twinning rate in this group was 61%. When only one top-quality blastocyst was available for transfer (21% of patients), the implantation and pregnancy rates were 50% and 70%. The twinning rate for this group was 50%. In contrast, when …