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Further Evidence that Single Embryo Transfer Yields Best Pregnancy Outcomes
May 13, 2013
Presented at the 2013 Annual Clinical Meeting of the American College of Obstetricians and Gynecologists (ACOG), a new study further proves the success of single embryo transfer (SET) with Preimplantation Genetic Screening (PGS) for optimal pregnancy outcomes.
There has been a recent push in the field of reproductive medicine toward SET, especially when combined with PGS for ensuring genetic normalcy of the embryo. The latest study shows that SET with PGS has favorable outcomes to double embryo transfer (DET) without genetic screening.
SET has reduced risk of multiples, therefore, better health outcomes for the mother and her offspring. Principle investigator on the study, Dr. Eric Forman of the UMDNJ-RWJMS/ Reproductive Medicine Associates of New Jersey says fertility treatments are responsible for about 18% of all twin births in the U.S., so a procedure like SET with PGS can significantly reduce multiple gestations which impose complications on the mother’s health and safety of childbirth.
“The technology exists today to make single-embryo transfer the standard of care across age groups, eliminating the vast majority of complications stemming from IVF, while maintaining excellent delivery rates for couples who have struggled with infertility,” Dr. Forman said.
For this study, 175 women aged 43 years or younger were recruited for SET with PGS or DET without genetic screening. Pregnancy rates were similar between the two groups, however, there was no incidence of twin gestation after SET and as high as 53% twin gestation in the DET group. Singleton pregnancy has less risk of preterm labor, premature birth, and low birth weight babies than a multiple gestation. Also, single gestation babies are less likely to spend time in the Neonatal Intensive Care Unit (NICU). Twins born after DET were more likely to be born prior to 34 weeks’ gestation.
Fertility patients often go ahead with a DET due to the fact that they are uneducated about the risks and do not fully understand the health benefits of SET. There is a common misconception that transferring multiple embryos will increase the rate of pregnancy. On the contrary, transferring multiple embryos only increases a patient’s risk of multiple gestation as pregnancy success is largely due to embryo quality rather than quantity.
Fertility doctors believe that the future of in vitro fertilization (IVF) will yield a significant trend toward SET as long as patients are thoroughly informed of the risks and benefits. Currently, fifteen states offer infertility insurance coverage, with only a fraction of those covering the costs of IVF. PGS is considered an elective procedure and is not covered by insurance. The average cost of IVF is about $12,000 per cycle in the United States and the cost of PGS averages an additional $4,000 per cycle.