title: Elective single embryo transfer in women aged 36-39 years.
abstract: BACKGROUND
  The elective single embryo transfer policy is the only effective strategy known to minimize the risk of multiple pregnancy. However, little is known about its applicability to women older than 35 years.
  
  
  METHODS
  Analysis was carried out on 1224 fresh IVF/ICSI cycles with embryo transfer and 828 frozen embryo transfer (FET) cycles of women aged 36-39 years. In the fresh cycles, 335 elective single top quality embryo (eSET), 110 elective single non top quality embryo (nt-eSET), 194 compulsory single embryo (cSET) and 585 double embryo transfers (DET) were carried out.
  
  
  RESULTS
  Pregnancy rate/embryo transfer (33.1 versus 29.9%) and live birth rate (26.0 versus 21.9%) in fresh cycles did not differ significantly between the eSET and the DET groups. However, women in the eSET group had a higher cumulative pregnancy rate (54.0% versus 35.0%) and a higher cumulative live birth rate (41.8% versus 26.7%, P < 0.0001) compared with those in the DET group. The cumulative multiple birth rate in the eSET group was 1.7%, whereas in the DET group it was 16.6% (P < 0.0001).
  
  
  CONCLUSIONS
  The eSET policy can be applied also to patients aged 36-39 years, reducing the risk of multiple birth and increasing the safety of assisted reproduction technique (ART) in this age group.
authors.affiliation: Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland.
authors.forename: Zdravka
authors.initials: Z
authors.lastname: Veleva
authors.forename: Sirpa
authors.initials: S
authors.lastname: Vilska
authors.forename: Christel
authors.initials: C
authors.lastname: Hydén-Granskog
authors.forename: Aila
authors.initials: A
authors.lastname: Tiitinen
authors.forename: Juha S
authors.initials: JS
authors.lastname: Tapanainen
authors.forename: Hannu
authors.initials: H
authors.lastname: Martikainen
mesh_terms: D000328:Adult; D015925:Cryopreservation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D012306:Risk; D020554:Sperm Injections, Intracytoplasmic