Evaluation of possible criteria for elective single embryo transfer

Abstract

Purpose A major problem of assisted reproductive technology (ART) is multiple gestation, which impacts neonatal and perinatal medicine. The literature contains a number of reports that elective single embryo transfer (eSET) is effective for the control of multiple pregnancies; however, to date, uniform criteria have not been established. Methods Using logistic regression analysis based on the results of ART in our department from January 2005 to July 2006, our eSET criteria were established. We conducted a comparative study of the clinical pregnancy rate, multiple gestation rate, and delivery rate before and after eSET (before-eSET and after-eSET groups, respectively). Results As a result of the analysis, our eSET criteria included all three of the following: (A) patient age B37, (B) previous IVF/ICSI trials B5, and (C) acquisition of two or more good-quality embryos. Based on our criteria, the after-eSET group was not found to have a decrease in the pregnancy rate; however, the multiple gestation rate decreased as compared to the before-eSET group. In addition, as a result of various evaluations of the eSET group, interesting findings were revealed. Conclusions In the after-eSET group, our eSET criteria achieved a decrease in the multiple pregnancy rate without a decrease in the pregnancy rate.

Comparisons of benefits and risks of single embryo transfer versus double embryo transfer: a systematic review and meta-analysis

“…Forty-five studies [ 2 , 11 , 13 , 15 , 21 , 24 , 28 – 31 , 38 , 39 , 43 , 44 , 48 – 50 , 53 , 54 , 56 – 59 , 62 , 64 , 66 – 69 , 72 , 75 – 77 , 79 – 81 , 85 – 87 , 91 , 93 – 96 , 98 ] were pooled and found that the MPR was significantly lower in the SET group than in the DET group (0.05, 0.04–0.06, I 2 = 2%, P < 0.001) (Supplementary Fig. S2 ).…”

“…S3 ). Forty-three studies [ 11 – 14 , 16 , 19 , 20 , 23 , 28 – 31 , 38 – 44 , 48 , 50 , 51 , 53 , 55 , 57 , 58 , 62 , 64 – 66 , 69 , 72 , 74 , 77 , 79 – 81 , 90 , 91 , 94 , 95 , 98 ] evaluated the miscarriage rates, and no significant difference was found between groups during the overall analysis (15.6% vs. 14.2%, 1.10, 0.95–1.27, I 2 = 30%, P = 0.211), neither in all the conducted subgroups (Supplementary Table S4 ). Seven studies [ 19 , 30 , 39 , 58 , 65 , 81 , 94 ] provided information on perinatal mortality, and no difference was observed (0.3% vs 0.7%, 0.71, 0.25–2.06, I 2 = 0%, P = 0.532).…”