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[Elective single embryo transfer - the Scandinavian experiment].
I Galeraud-Denis1, C Denoual-Ziad, C Muris-Guillou
1Unité de Biologie, Centre d'assistance Médicale à la Procréation, 14033 Caen cedex, France. denis-i@chu-caen.fr
Gynecologie, Obstetrique & Fertilite
|October 28, 2008
Summary
Reducing embryo transfers to two still results in high twin rates. Elective single embryo transfer (eSET) effectively minimizes twins but may lower live birth rates, requiring careful patient selection and optimized protocols.
Area of Science:
- Reproductive Medicine
- In Vitro Fertilization (IVF)
- Maternal-Fetal Medicine
Context:
- Multiple pregnancies carry significant maternal, neonatal, and psychological risks.
- Elective single embryo transfer (eSET) emerged as a strategy to mitigate these risks.
- Previous studies focused on selected IVF populations.
Purpose:
- To evaluate the effectiveness of eSET versus double embryo transfer (DET) in reducing twin pregnancies.
- To analyze the impact of eSET on live birth rates.
- To discuss the extension of eSET to unselected patient populations.
Summary:
- Transferring two embryos does not significantly decrease twin pregnancy rates (21-40%).
- eSET has shown success in nearly eliminating twins in selected groups, though live birth rates require optimization.
- Factors like patient age and embryo quality influence eSET success.
- Extending eSET to unselected populations remains debated, balancing twin reduction against overall pregnancy rates.
Impact:
- eSET offers a pathway to significantly reduce multiple births and associated complications.
- Optimizing eSET requires integrating embryo freezing and identifying predictive factors for success.
- The decision to implement eSET broadly necessitates a societal consensus on acceptable twin pregnancy rates versus overall IVF success rates.
