An Elective Single Embryo Transfer (eSET) is the practice of transferring only one embryo into a woman’s uterus. This offers a reduced chance of multiples while maintaining a very similar rate of pregnancy. Due to the reduced risk of an eSET along with having a very similar rate of pregnancy, eSET has quickly become the gold standard practice of transferring embryos with an IVF procedure.
There was a time in its infancy where reproductive endocrinologists and other fertility specialists would routinely transfer multiple embryos. This practice was largely due to the uncertainty of individual embryo health and ability to implant. By transferring multiple embryos, clinics were able to “improve,” their success rates and boast superiority over other clinics. This outdated practice has developed some unwarranted “fear,” as people often think that if they do IVF that they will automatically have twins or in rare cases even higher number of multiples.
Today, with improved embryology and medical techniques, it is not only unnecessary but unsafe and at times unethical to transfer multiple embryos when a client has a good prognosis for success. This does not mean that multiple embryos are not transferred, it simply means that each case at CNY Fertility is treated individually.
Because of the substantial risks associated with multiple births and minimal increase to the chance of a positive pregnancy test, transferring single embryos in an “eSET” is the often the right choice to make when deciding to transfer.
It is important to keep in mind that this very serious decision will always be discussed with your provider. Each case is analyzed individually. Often times, clients come to us after having tried to conceive for many years and hope that by transferring more embryos, they will improve their chance of conception. While this may be the case for some, it is not the case for everyone. In some instances, when the prognosis for a successful clinical pregnancy are low, we may recommend transferring multiple embryos. For others, it will be a personal choice which is truly an ELECTIVE single embryo transfer. For others still, it will be a medical necessity to transfer a single embryo.
Years of clinical experience and published data has shown that there is a substantial risk associated with multiple pregnancies. We make recommendations on the number to transfer based on the ASRM guidelines. ASRM recommends a single embryo transfer in all patients under 38 years of age as well as all PGS euploid embryos. CNY uses these guidelines, along with your history to suggest single embryo transfers when appropriate.
The risks of multiples during gestation and birth include but are not limited to:
- Premature birth
- Prolonged bed rest
- Gestational diabetes
- Pregnancy-induced hypertension
- Increased need for cesarean section
- Postpartum depression
- Growth of all fetuses
- Developmental disabilities
- Cerebral palsy
- Infant mortality rates