The issue of multiple births as a result of fertility treatments is frequently in the news. Aside from the ethical issues raised by this event, important health-related concerns have highlighted a growing trend to perform elective single embryo transfers (SET). Today, with better techniques for growing and selecting the best quality embryos, transferring one embryo instead of two or more to minimize the risk of multiple births is a viable option for some infertile women undergoing IVF without compromising their chance of a successful pregnancy. In fact, our results have shown that pregnancy rates with SET are as good as those resulting from transferring more embryos.
The recommendations of the American Society for Reproductive Medicine advise a single embryo transfer in women younger than 35. Women/couples who don’t want to risk multiple pregnancies or who have a preexisting medical condition for which a multiple pregnancy would not be safe, should also consider a single embryo transfer.
It is important to us and our patients that the pregnancy rates with single embryo transfer are as good as those resulting from transferring more embryos. Our results (2009-2013) after transferring a single blastocyst compared to transferring multiple blastocysts for patients under the age of 35 are presented below.
|Single embryo transfer||Transfer of 2 or more embryos|
|Clinical pregnancy rate (pregnancies/transfers)||64.4% (257/399)||66.5% (131/197)|
|Live birth rate (live born/transfers)||57.4% (229/399)||57.4 % (113/197)|
|Twin rate (twin pregnancies/clinical pregnancies)||3.9% (10/257)||38.9% (51/131)|
|Triplet rate (triplet pregnancies/clinical pregnancies)||0||3.8% (5/131)|
The Center is a leader in its utilization of single embryo transfer, committed to maximizing patients’ success with as few embryos transferred as possible. Multiple births carry a number of risks, including prematurity, low-birth rate, learning disabilities, and developmental problems for the infants, and high blood pressure, gestational diabetes, and cesarean section for the mothers. And of course this also increases the costs for the delivery and subsequent hospital stay.
Read our Center’s publication on the importance of the level of insurance coverage on a couple’s desire for SET.
Our goal is to continue to improve outcomes for all IVF patients, and to achieve the highest live birth from single embryo transfers, when clinically indicated. In fact, we are a leader in this initiative, as members of the SMART (States Monitoring Assisted Reproductive Technology) Collaborative. The purpose of SMART is to establish, evaluate, improve and promote state-based surveillance of Assisted Reproductive Technology, infertility, and related activities which can be used to monitor and study maternal and infant health outcomes related to ART.
Patients are advised to consult with their physician and decide if it makes sense in their particular circumstance.