Assisted reproduction is most effectively done using single embryos – rather than procedures that can lead to multiple births, researchers reported yesterday.
Traditionally clinics have used multiple embryos to improve a woman’s chance of conception – but this has placed women at risk of giving birth to twins or even more children.
A new study finds that transferring single embryos to a woman over several assisted reproduction cycles that use both fresh and frozen embryos is more effective and cheaper than transferring two or more embryos at a time.
Those were the findings of an extensive Finnish study published online today in the journal Human Reproduction.
Researchers from the University of Oulu said the results refuted any concerns about the cost of an eSET (elective single embryo transfer) policy and the fears it could lead to fewer live births.
Dr Hannu Martikainen and colleagues compared the outcomes of two IVF/ICSI cycles over two time periods at their fertility clinic; one when double embryo transfer (DET) was more common and one when eSET was used more widely.
Over the 10 year period, 1510 women younger than 40 years were treated at the clinic.
The researchers found the cumulative pregnancy rate and cumulative live birth rate per egg retrieval (ovum pick-up) and the cumulative live birth rate per woman were all higher in the eSET period.
Dr Martikainen said eSET, together with an effective embryo freezing programme, led to better outcome and lower treatment costs for women under 40 having IVF, ICSI, or both.
A second paper published in the same journal examined the cost-effectiveness of eSET, DET and combinations of these strategies.
Led by Dr Audrey Fiddelers from the Academic Hospital Maastricht in The Netherlands, researchers found that combining several different transfer policies (eSET, DET or standard treatment) was not cost-effective.
“If society is willing to pay less than 7,350 euros for one extra live birth, then three cycles of eSET are to be preferred,” she said.
Human Reproduction, March 25, 2009. doi:10.1093/humrep/dep052, doi:10.1093/humrep/dep041
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