[Elective single embryo transfer: a justified policy for selected patients]

Area of Science:

• Reproductive Medicine
• Assisted Reproductive Technology (ART)
• Embryology

Context:

• Increasing rates of twin pregnancies in ART necessitate strategies for safer outcomes.
• Elective Single Embryo Transfer (e-SET) is gaining acceptance as a standard of care.
• Patient selection and laboratory performance are critical for successful e-SET implementation.

Purpose:

• To prospectively evaluate the efficacy of e-SET in reducing twin pregnancies.
• To assess the Take Home Baby Rate per couple as the primary outcome measure.
• To compare e-SET outcomes with Double Embryo Transfer (DET) in a selected patient group.

Summary:

• A prospective study compared e-SET with DET in women over 37 undergoing their first IVF/ICSI attempt.
• e-SET was performed when at least one high-quality embryo was available for transfer and another for freezing.
• While cumulative delivery rates were similar (39.5% e-SET vs. 41.7% DET), twin pregnancy rates were significantly lower with e-SET (2.6% vs. 26.6%).

Impact:

• e-SET significantly reduces the incidence of twin pregnancies without compromising overall delivery rates in selected first-time IVF/ICSI patients.
• This strategy is particularly beneficial in fertility clinics with robust embryo cryopreservation programs.
• Implementation of e-SET can enhance patient safety and reduce the risks associated with multiple gestations.