Elective single embryo transfer- the power of one

Area of Science:

• Reproductive Medicine
• Obstetrics & Gynecology

Background:

• In vitro fertilization (IVF) historically has high success rates but has led to an epidemic of twin and higher-order gestations.
• Advances in cryopreservation, culture systems, and embryo selection enable fewer embryo transfers with maintained pregnancy rates.

Purpose of the Study:

• To review the evolution and future applications of elective single embryo transfer (eSET).
• To highlight the practice's role in reducing iatrogenic multiple gestations from IVF.

Main Methods:

• Review of literature on IVF, embryo transfer practices, and multiple gestation rates.
• Analysis of the impact of eSET on singleton pregnancy rates and overall IVF success.
• Examination of eSET adoption rates and associated healthcare outcomes.

Main Results:

• Elective single embryo transfer (eSET) significantly reduces multiple gestation rates.
• eSET maximizes singleton pregnancy rates while maintaining overall IVF success.
• States with mandated IVF insurance and eSET show decreased preterm birth rates and healthcare savings.

Conclusions:

• eSET is a crucial practice for minimizing iatrogenic twins in IVF.
• Wider adoption of eSET in the US is recommended to improve maternal and infant outcomes.
• Future applications of eSET can further reduce risks associated with assisted reproductive technologies.