Single embryo transfer
Most IVF .specialists have used multiple embryo transfer in the hope of achieving better pregnancy and "take-home-baby" rates.
They did not have to "pick up the pieces" in prematurity and neonatal mortality and morbidity.
Advice from the Human Fertilisation & Embryology Authority (HFEA) and similar bodies now strongly favours elective single-embryo transfer (eSET).
The HFEA issued a statement in October 2008 recognising the "overwhelming" case to deal with multiple pregnancy arising from IVF.
This was against a background of a belief that eSET would result in lower pregnancy rates.
But that this was a price worth paying to reduce the neonatal consequences of prematurity due to multiple pregnancy.
It is reassuring, therefore, that a paper from Finland in 2009 showed that eSET was more effective and cheaper than double-embryo transfer (DET).
From 1995 - 1999, DET was the usual procedure in the authors' clinic in Oulu.
From 200 - 2004, almost half of the procedures used eSET.
DET was used for 826 women.
There were 1359 fresh embryo cycles and 589 frozen embryo transfer (FET) cycles.
The corresponding figures for eSET were 684 women who had 1027 fresh embryo and 683 FET cycles.
The results were:
| eSET | DET | |
| cumulative pregnancy rate | 38.2% | 33.1% |
| cumulative live-birth rate | 28% | 22.5% |
| multiple pregnancy rate | 8.9% | 19.6% |
The authors calculated that overall an eSET live-birth was nearly 20,000 euros cheaper than a DET live-birth.
Not surprisingly, they concluded that eSET "should be adopted as a treatment of choice".
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