Elective single embryo transfer

Czech version

Authors: M. Poláková
Authors‘ workplace: GEST IVF, Centrum reprodukční medicíny ; Nad Buďánkami II/24, 150 00 Praha ⁵
Published in: Prakt Gyn 2010; 14(3): 128-132
Category: Review Article

Overview

Aim:
Sterility treatment, through assisted reproductive techniques, has brought about an unprecedented increase in multiple pregnancies (MP) worldwide. Are we able, by transferring one embryo only under clearly defined conditions, to significantly affect this adverse trend without a negative impact on results of assisted reproduction? Is it possible to apply elective single embryo transfer (eSET) in all IVF centres?

Methods:
The present review paper analyzes current situation in eSET application in the Czech Republic and worldwide.

Results:
Success of eSET programmes can be judged by comparing cumulative pregnancy rates (PR) after eSET and frozen-thawed embryo (FET), with double embryo transfer (DET) PR. Although there are great differences among studies, it is possible to say that there is always at least a mild decrease in PR in eSET+FET groups in comparison to DET (difference 4–11%). However, PR in eSET+FET group is, in these studies, rather high – a minimum of 38% – and a decrease in twin pregnancies is significant.

Conclusion:
The decision to apply eSET must be weighed by each IVF centre on the basis of its own actual results. Only the IVF laboratories with good long-term results have the capacity for twin pregnancy reduction through eSET. The conclusion we draw depends on our priorities. We can offer a mild decrease of PR for considerable reduction of twin pregnancies. From an economic point of view, when satisfactory PR is established in an eSET+FET programme, short-term costs caused by higher numbers of embryo transfers are outweighed by lower long-term care costs for new-born babies. On the basis of these economic advantages, the state and insurance companies should encourage IVF centres and patients to apply the eSET programmes, when appropriate.

Key words:
IVF/ICSI – multiple pregnancies – embryo selection – single embryo transfer

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Labels

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Article was published in

Practical Gynecology

2010 Issue 3