Elective single ET improves, but does not completely eliminate the risk of multiple pregnancies. Patients should be counseled that there might be up to a ∼2% risk of multiple pregnancies, of which up to 18% can be dizygotic. Patients with elevated BMI and unexplained fertility may be at higher risk for sex discordant multiple pregnancies and patients undergoing fresh cycles may be at higher risk for sex concordant multiple pregnancies.

Objective To determine if mandatory online training in electronic fetal monitoring (EFM) improved agreement in documentation between obstetric care providers and nurses on labor and delivery. Methods Health care professionals working in obstetrics at our institution were required to complete a course on EFM interpretation. We performed a retrospective chart review of 701 charts including patients delivered before and after the introduction of the course to evaluate agreement among providers in their documentation of their interpretations of the EFM tracings. Results Agreement between provider and nurse documentation at the time of admission improved for variability and accelerations (variability: 91.1 vs. 98.3%, p < 0.001; and accelerations: 75.2 vs. 87.7%, p < 0.001). Similarly, agreement improved at the time of the last note prior to delivery for documentation of variability and accelerations (variability: 82.1 vs. 90.6%, p = 0.001; and accelerations: 56.7 vs. 68.6%, p = 0.0012). Agreement in interpretation of decelerations both at the time of admission and at the time of delivery increased (86.3 vs. 90.6%, p = 0.0787, and 56.7 vs. 61.1%, p = 0.2314, respectively) but was not significant. Conclusion An online EFM course can significantly improve consistency in multidisciplinary documentation of fetal heart rate tracing interpretation.

Singletons resulting from d-FET are at increased risk for perinatal morbidity. However, the risk was diminished in single blastocyst transfer cycles. Our study supports the current American Society for Reproductive Medicine (ASRM) guidelines of transferring a single blastocyst in d-FET cycles.