Two cycles with single embryo transfer versus one cycle with double embryo transfer: a randomized controlled trial

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization (IVF)
• Health Economics

Background:

• Multiple pregnancies after IVF pose significant risks and increase healthcare costs.
• Investigating alternative embryo transfer strategies is crucial for improving IVF outcomes and patient safety.

Purpose of the Study:

• To compare the effectiveness and cost-effectiveness of two cycles of single embryo transfer (SET) versus one cycle of double embryo transfer (DET) after IVF.
• To evaluate the impact of SET and DET on live birth rates and multiple pregnancy rates.

Main Methods:

• A randomized controlled trial involving 107 women under 35 undergoing their first IVF cycle.
• Participants with at least one good quality embryo were randomized to either SET (n=54) or DET (n=53).
• Outcomes measured included cumulative live birth rates, multiple pregnancy rates, and medical costs.

Main Results:

• Comparable cumulative live birth rates were observed: 41% for two SET cycles versus 36% for one DET cycle.
• The multiple pregnancy rate was significantly higher in the DET group (37%) compared to the SET group (0%).
• Total medical costs per live birth were similar initially, but SET offered substantial long-term savings when considering costs associated with handicaps.

Conclusions:

• Two cycles of SET are as effective as one cycle of DET in achieving live births following IVF.
• SET significantly reduces the incidence of multiple pregnancies, enhancing safety and potentially lowering overall healthcare expenditure.
• Implementing SET is recommended for IVF patients due to its comparable efficacy, improved safety profile, and long-term economic benefits.