Practice patterns and outcomes with the use of single embryo transfer in the United States.
OBJECTIVE
To evaluate factors associated with the use of elective single embryo transfer (eSET) and its effect on assisted reproductive technology (ART) outcome.


METHODS
Historical cohort.


METHODS
Clinic-based data.


METHODS
A total of 69,028 ART cycles of autologous fresh embryo transfers with additional embryos cryopreserved during the same cycle performed during 2004-06 and reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database.


METHODS
None.


METHODS
Factors associated with the number of embryos transferred, and the odds of pregnancy, live birth, and multiple-infant live birth by number of embryos transferred as adjusted odds ratios (AORs).


RESULTS
Single embryo transfer was used more with uterine factor (AOR 1.76) and less with male factor, endometriosis, or tubal factor (AOR 0.81, 0.72, 0.83, respectively). Compared with women aged <30 years, eSET was used less among women aged 35-39 years and > or =40 years (AOR 0.74 and 0.39, respectively). Compared with White women, eSET was used more with Asian (AOR 1.52) and less with Black or Hispanic women (AOR 0.73 and 0.67, respectively). Compared with eSET, the likelihood of pregnancy, live birth, or multiple-infant live birth was more likely with two embryos (AOR 1.33, 1.34, and 27.4, respectively).


CONCLUSIONS
Elective SET, used more for younger women with specific diagnoses, is associated with slightly reduced likelihood of a live birth but much reduced likelihood of multiples.
Department of Obstetrics, Gynecology, and Reproductive Biology and Department of Epidemiology, Michigan State University, B227 West Fee Hall, East Lansing, Michigan 48824, USA. lukeb@msu.edu
Barbara
B
Luke
Morton B
MB
Brown
David A
DA
Grainger
Marcelle
M
Cedars
Nancy
N
Klein
Judy E
JE
Stern
D000328:Adult; D005006:Ethnicity; D005260:Female; D005318:Fetal Heart / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000209:etiology; D008297:Male; D008423:Maternal Age; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D044469:Racial Groups; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D056826:Single Embryo Transfer / Q000379:methods*; D014310:Triplets; D014427:Twins; D016216:Ultrasonography, Prenatal; D055815:Young Adult