Hum. Reprod. Advance Access originally published online on February 22, 2006
Human Reproduction 2006 21(6):1337-1344; doi:10.1093/humrep/del026
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
DEBATE—CONTINUED
The relative myth of elective single embryo transfer
1 Center for Human Reproduction, New York, NY, 2 Foundation for Reproductive Medicine, 3 Department of Obstetrics and Gynecology, Yale University School of Medicine, Chicago, IL and 4 Department of Epidemiology and Social Medicine and Department of Obstetrics and Obstetrics and Gynecology & Women’s Health, Albert Einstein College of Medicine, Bronx, NY, USA
5 To whom correspondence should be addressed at: Center for Human Reproduction, 21 East 69th Street, New York, NY 10021, USA. E-mail: ngleicher{at}thechr.com
The option of single embryo transfer (SET) has recently dominated the pages of this and other medical journals. Opinions, in regards to the utility of such an approach, appear to differ between Europe and the US. While US guidelines promote a more individualized approach, European opinions, at times, even advocate mandated practice patterns. The European approach, however, fails to recognize the rather significant differences in supportive arguments between the historical switch from multiple embryo transfers to 2-embryo transfers and the current discussion, favouring a switch from 2-embryo transfer to elective (e)-SET. In the former, a significant risk of (at times, high-order) multiple pregnancies was reduced without loss of pregnancy potential. In the latter, a comparably relatively low twinning risk is reduced at the expense of declining pregnancy rates, a need for more treatment cycles, a potential delay in treatment success and, potentially, higher treatment costs. These consequences of e-SET, together with the preference of some infertility patients to actually conceive twins, raise serious questions about the wide utilization of e-SET, as has been propagated by many authorities. According to US guidelines, e-SET, therefore, appears to represent an appropriate transfer option for only a small minority of IVF patients. Argument in favour of indiscriminate SET appears unrealistic and should be reconsidered.
Key words: embryo transfer/IVF/IVF risks/multiple births
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Z. Veleva, P. Karinen, C. Tomas, J. S. Tapanainen, and H. Martikainen Elective single embryo transfer with cryopreservation improves the outcome and diminishes the costs of IVF/ICSI Hum. Reprod., July 1, 2009; 24(7): 1632 - 1639. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.M. van Peperstraten, R.P.M.G. Hermens, W.L.D.M. Nelen, P.F.M. Stalmeier, G.J. Scheffer, R.P.T.M. Grol, and J.A.M. Kremer Perceived barriers to elective single embryo transfer among IVF professionals: a national survey Hum. Reprod., December 1, 2008; 23(12): 2718 - 2723. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.M. van Peperstraten, W.L.D.M. Nelen, R.P.M.G Hermens, L. Jansen, E. Scheenjes, D.D.M. Braat, R.P.T.M. Grol, and J.A.M. Kremer Why don't we perform elective single embryo transfer? A qualitative study among IVF patients and professionals Hum. Reprod., September 1, 2008; 23(9): 2036 - 2042. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Castilla, J. Hernandez, Y. Cabello, A. Lafuente, N. Pajuelo, J. Marqueta, B. Coroleu, and (Assisted Reproductive Technology Register of the Defining poor and optimum performance in an IVF programme Hum. Reprod., January 1, 2008; 23(1): 85 - 90. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.O. Karlstrom and C. Bergh Reducing the number of embryos transferred in Sweden-impact on delivery and multiple birth rates Hum. Reprod., August 1, 2007; 22(8): 2202 - 2207. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Belaisch-Allart Is twin pregnancy necessarily an adverse outcome of assisted reproductive technologies? Hum. Reprod., May 1, 2007; 22(5): 1495 - 1495. [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Stillman A 47-Year-Old Woman With Fertility Problems Who Desires a Multiple Pregnancy JAMA, February 28, 2007; 297(8): 858 - 867. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Gleicher, A. Weghofer, and D. Barad On the benefit of assisted reproduction techniques, a comparison of the USA and Europe Hum. Reprod., February 1, 2007; 22(2): 624 - 626. [Full Text] [PDF]
|
|