eSET irrespective of the availability of a good-quality embryo in the first cycle only is not effective in reducing overall twin pregnancy rates.
BACKGROUND
In several clinics, elective single-embryo transfer (eSET) is applied in a selected group of patients based on age and the availability of a good-quality embryo. Whether or not eSET can be applied irrespective of the presence of a good-quality embryo in the first cycle, to further reduce the twin pregnancy rate, remains to be elucidated.


METHODS
In patients <38 years two transfer strategies were compared, which differed in the first cycle only: group A (n = 141) received eSET irrespective of the availability of a good-quality embryo, and group B (n = 174) received eSET when a good-quality embryo was available while otherwise they received double embryo transfer (DET; referred to as eSET/DET transfer policy). In any subsequent cycle, in both groups the eSET/DET transfer policy was applied.


RESULTS
After completion of their IVF treatment (including a maximum of three fresh cycles and the transfer of frozen-thawed embryos), comparable cumulative live birth rates (62.4% in group A and 62.6% in group B) and twin pregnancy rates (10.1 versus 13.4%) were found. However, patients in group A required significantly more fresh (2.0 versus 1.8) and frozen (0.8 versus 0.5) cycles.


CONCLUSIONS
The transfer of one embryo in the first cycle, irrespective of the availability of a good-quality embryo, in all patients <38 years, is not an effective transfer policy for reducing the overall twin pregnancy rate.
van Montfoort
Aafke P A
AP
Research Institute Growth & Development (GROW), Department of Obstetrics and Gynaecology, Academic Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. avmn@sgyn.azm.nl
Fiddelers
Audrey A A
AA
Land
Jolande A
JA
Dirksen
Carmen D
CD
Severens
Johan L
JL
Geraedts
Joep P M
JP
Evers
Johannes L H
JL
Dumoulin
John C M
JC
D000328:Adult; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D014427:Twins