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Elective Single-Embryo Transfers: A paradigm between risks of multiple pregnancies, patient’s expectations and demands, and a patient-centric autonomic environment

In the early days of IVF, the goal of treatment was to maximize the chance of achieving a pregnancy by transferring several embryos, regardless of any known complications created by multiple-order pregnancies.1,2  It has since been shown that the risk of multiple-order births increases with the number of embryos being transferred.  In 2009, for Assisted Reproductive Technology (ART) the CDC reported a national multiple pregnancy rate of 31.6%, with 28.5% rate for twin pregnancies and 3.1% for triplet or higher-order multiples.3

The implementation of elective single embryo transfer (eSET) in an IVF program would provide the opportunity for success without creating complications. Unfortunately, an existing paradigm of eSET does make its implementation in a clinical setting very difficult. That in turn can have an impact on patient’s expectations and demands.  On the other hand, support for the widespread of eSET seems to be a) the increasing success rate of eSET, b) a patient-centric environment including patient autonomy, and c) that education delivers awareness of the associated risks of multiple pregnancies.

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