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Hum. Reprod. Advance Access published online on June 1, 2006
Human Reproduction, doi:10.1093/humrep/del137
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received December 8, 2005
Revised March 28, 2006
Accepted April 5, 2006

Article

Elective single embryo transfer in women aged 36-39 years

Zdravka Veleva 1, Sirpa Vilska 2, Christel Hydén-Granskog 3, Aila Tiitinen 3, Juha S. Tapanainen 1, and Hannu Martikainen 1 *

1 Department of Obstetrics and Gynecology, University of Oulu, Oulu
2 Infertility Clinic, Family Federation of Finland
3 Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland

* To whom correspondence should be addressed.
Hannu Martikainen, E-mail: hmartika{at}cc.oulu.fi


  Abstract

BACKGROUND: The elective single embryo transfer policy is the only effective strategy known to minimize the risk of multiple pregnancy. However, little is known about its applicability to women older than 35 years. METHODS: Analysis was carried out on 1224 fresh IVF/ICSI cycles with embryo transfer and 828 frozen embryo transfer (FET) cycles of women aged 36-39 years. In the fresh cycles, 335 elective single top quality embryo (eSET), 110 elective single non top quality embryo (nt-eSET), 194 compulsory single embryo (cSET) and 585 double embryo transfers (DET) were carried out. RESULTS: Pregnancy rate/embryo transfer (33.1 versus 29.9%) and live birth rate (26.0 versus 21.9%) in fresh cycles did not differ significantly between the eSET and the DET groups. However, women in the eSET group had a higher cumulative pregnancy rate (54.0% versus 35.0%) and a higher cumulative live birth rate (41.8% versus 26.7%, P < 0.0001) compared with those in the DET group. The cumulative multiple birth rate in the eSET group was 1.7%, whereas in the DET group it was 16.6% (P < 0.0001). CONCLUSIONS: The eSET policy can be applied also to patients aged 36-39 years, reducing the risk of multiple birth and increasing the safety of assisted reproduction technique (ART) in this age group.

Keywords: cryopreservation/elective single embryo transfer/female age/ICSI outcome/IVF.
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