Mandatory single embryo transfer policy dramatically decreases multiple pregnancy rates.
OBJECTIVE
The aim of this study is to determine the effect of a mandatory single embryo transfer (SET) policy on pregnancy rates and multiple pregnancy rates in intracytoplasmic sperm injection (ICSI) cycles.


METHODS
One hundred and twenty-eight patients (154 cycles) underwent ICSI before the Turkish Ministry of Health's legislation, 55 patients (69 cycles) underwent ICSI after the legislation (day-3 embryo transfers only) and 35 patients (39 cycles) who underwent ICSI after the legislation (day-5 embryo transfers only).


RESULTS
Groups were comparable regarding the women's mean age and body mass index. The number of embryos transferred (2.7 ± 0.5 vs 1.0 ± 0.0 vs 1.0 ± 0.0) was significantly higher in group I, compared to group II and group III. Clinical pregnancy per embryo transfer (40.8% vs 15.1% vs 36.1%) and live birth rate (37.7% vs 13.2% vs 30.6%) were significantly lower in group II when compared to group I and group III. Multiple pregnancy rates (39.6% vs 0.0%, vs 0.0%) were significantly higher in group I when compared to group II and III. Implantation rates were significantly higher in group III when compared to group I and group II. Miscarriage rates were comparable among the groups.


CONCLUSIONS
The mandatory SET policy caused a dramatic decrease of multiple pregnancy rates. Mandatory SET with only day-3 embryo transfers decreased the pregnancy rates but this detrimental effect was not seen in cycles with day-5 embryo transfers.
Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Ibrahim
I
Esinler
Gurkan
G
Bozdag
Lale
L
Karakoc Sokmensuer
D004477:Ectogenesis; D016656:Family Planning Policy / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007878:Legislation as Topic; D050498:Live Birth; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D056826:Single Embryo Transfer; D020554:Sperm Injections, Intracytoplasmic; D014421:Turkey
assisted reproductive technology; intracytoplasmic sperm injection; mandatory single embryo transfer; multiple pregnancies; single embryo transfer