title: Elective Single Embryo Transfer: an update to UK Best Practice Guidelines.
abstract: A significant number of multiple pregnancies and births worldwide continue to occur following treatment with Assisted Reproductive Technologies (ARTs). Whilst efforts have been made to increase the proportion of elective single embryo transfer (eSET) cycles, the multiple pregnancy rate or MPR remains at a level that most consider unacceptable given the associated clinical risks to mothers and babies, and the additional costs associated with neonatal care of premature and low birth weight babies. Northern Europe, Australia and Japan have continued to lead the way in the adoption of eSET. Randomised controlled trials or RCTs, meta-analyses and economic analyses support the implementation of an eSET policy, particularly in light of recent advances in ARTs. This paper provides a review of current evidence and an update to the eSET guidelines first published by Cutting et al. (2008) intended to assist ART clinics in the implementation of an effective eSET policy.
authors.affiliation: a Cambridge IVF, Cambridge University Hospitals NHS Trust, Kefford House , Maris Lane Cambridge , UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Harbottle
authors.affiliation: b HARI Clinic, Rotunda Hospital , Dublin , Eire.
authors.forename: Ciara
authors.initials: C
authors.lastname: Hughes
authors.affiliation: c Jessop Fertility, The Jessop Wing, Tree Root Walk , Sheffield , UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Cutting
authors.affiliation: d Center for Biostatistics, Institute of Population Health, University of Manchester , Oxford Road, Manchester , UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Roberts
authors.affiliation: e Department of Reproductive Medicine , Old St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre , Oxford Road, Manchester , UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Brison
mesh_terms: D001315:Australia; D001755:Blastocyst / Q000145:classification / Q000502:physiology; D015925:Cryopreservation; D004624:Embryo Transfer; D005060:Europe; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007564:Japan; D010353:Patient Education as Topic; D011050:Policy Making; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D019836:Preimplantation Diagnosis; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012307:Risk Factors; D056826:Single Embryo Transfer / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D013480:Superovulation; D006113:United Kingdom
keywords: ACE; ART; BFS; Elective single embryo transfer (eSET); ICSI; IVF; guidelines; multiple pregnancy