Toward Single Embryo Transfer, The Power of One

The twin birth rate has increased by more than ۷۵ % since۱۹۸۰, mainly due to the use of assis ted reproductive technology(ART). Transfer of multiple embryos increases the riskof twin or higher order pregnancies which is associated withsignificant health risks and maternal and neonatal complications.Despite of physical, emotional, and financial s tresses,multiple pregnancies also might increase the incidence ofdepression and anxiety disorders and all efforts in in vitrofertilization (IVF) clinics should emphasize on this goal,the delivery of a healthy single baby, with fewer twin andhigher-order births.Per single IVF attempt, overall birth rate is higher with doubleembryo transfer (DET), however the cumulative livebirth rates with elective single embryo transfer (eSET) followedby transfer of a single frozen embryo were similar tothose seen with a single DET, with significantly lower twinbirth rate associated with SET. Multiple barriers exis t towardapplication of SET as a routine procedure in IVF practices,however s trategies like patient education and decision aids,counseling and advice from physicians and nurses, financialincentives and using prediction tools, would help patients tochoose single embryo be transferred. Engagement of comprehensivechromosomal screening (CCS) technologies intothe routine IVF procedures would help clinicians to assessembryos for aneuploidy before transfer and can increases theimplantation and pregnancy rates and in the case of transferof good quality embryo on Day ۵, the live birth rate even canbe as good as ۷۰%.eSET is considered as the mos t effective method for reducingmultiple pregnancies resulting from IVF and for patient ageof <۳۶ with good prognosis, eSET should be consis tently encouraged.In the absence of public policies to reduce multiplepregnancies, individual IVF centers can develop mandatorySET policies for all or certain subsets of their patients.

کلیدواژه ها:

Multiple Pregnancy ، Single Embryo Transfer ، Aneuploidy ، Patient Consultation