Elective single embryo transfer is the decision to transfer only one embryo at a time, even if more than one embryo is available for transfer. Recently, this concept has been highly publicized as the optimal method of performing embryo transfer after IVF, as it is the best way to avoid twin pregnancy. Proponents of eSET believe twins are a dangerous outcome of creating a pregnancy and should be avoided whenever possible. In fact, many IVF programs , including several in this area, refuse to allow many or even all couples to transfer more than a single embryo, stating that it is unethical to risk multiple pregnancy.
We at WFI agree that there are times when eSET is highly desirable. However, we also believe that there are situations where two, three, or even more embryos can be safely transferred. Furthermore, the physicians at WFI believe that the choice of how many embryos to transfer is ultimately that of the couple being treated, and it is our job to simply educate you regarding the risks and benefits of different approaches. We are not paternalistic or dogmatic; rather, we believe you have the ability to best choose what is right for you!
Proponents of eSET argue that two single embryo transfers have the same chance of pregnancy as a two embryo transfer, but without the risk of twins. However, the facts paint a different picture: the rate of pregnancy is 7% higher with a two embryo transfer than with two eSETs. Furthermore, there is additional time, expense, and effort required of the patient to undergo two rather than one transfer.
Also relevant is the fact that twin pregnancies are riskier than singleton pregnancies. It is true that a twin pregnancy does pose an increased risk compared to a pregnancy with only one child born. However, when a twin pregnancy is compared to TWO singleton pregnancies, there is virtually no difference in risk. Thus, for couples that desire more than one child from IVF, the “risk” of twins actually means less cost, time, and inconvenience with no additional threat to the mother’s or baby’s health.
The Wisconsin Fertility Institute believes in practicing safe, ethical medical care, and we believe eSET is an excellent option for some women. However, for many others the transfer of a single embryo is wasteful and detrimental. We will provide you with the information you need to determine of which group you may want to be a member.