Elective Single Embryo Transfer at West Coast Fertility Center
The option to transfer one fresh embryo followed by one thawed embryo, if needed, offers the highest chance for some IVF patients to have a baby without increasing the risk of twins. - U.S. Dept of Health and Human Services.
ELECTIVE SINGLE EMBRYO TRANSFER (e-SET) at West Coast Fertility
SINGLE EMBRYO TRANSFER: Since 2010, the policy of West Coast Fertility has been to strongly recommend the elective transfer of ONE fresh embryo (e-SET) to women in the favorable age group less than 38 years of age. If necessary, in a subsequent cycle we advocate for transfer of a single frozen embryo.
OUTCOME of Single Embryo Transfer: As a result of this strategy, the success rate of having at least one baby has been in the cumulative range of ~ 40 to 50% with a less than 1% risk of twins. Culturing embryos to the 5th day blastocyst stage has yielded slightly higher cumulative rates of ~ 55%.
TWO EMBRYO TRANSFER: At West Coast Fertility, the transfer of 2 embryos cultured to day 3 stage did not increase the odds of achieving pregnancy in our favorable age group patients under 38 years of age. However the occurrence of twins increased dramatically.When embryos were cultured to the more advanced stage day 5 blastocyst, the incidence twins increased significantly.
OUTCOME of Two Embryo Transfer: A critical discussion held with our patients is to stress the fact that "twins is not a normal pregnancy." There is a common misconception that if transferring one embryo is good, then transferring two embryos must be better. Interestingly, this is a falsehood since our data suggest that the transfer of two embryos yielded a pregnancy rate between 50% - 60%. However this came at the cost of an important rise in twins between 15% - 30%. In our opinion, this minimal rise in pregnancy rate is not justified in light of the maternal and fetal risks associated with twins.
DONOR EGG PREGNANCY At West Coast Fertility the use of donor eggs in a patient of any age, mirrors the odds of achieving pregnancy in our favorable age group patients regardless of the recipient's age. Therefore, in this subgroup of patients, our policy is to advocate for the transfer of e-SET.
OUTCOME of Donor Egg Pregnancy: Using donor eggs appears to replicate the success rate we find in our favorable age group patients likely due to the development of euploid embryos. A recent review of our donor egg program documents a 50% pregnancy rate in agreement with our thesis. All our patients using donor eggs are advised to transfer a single day 5 blastocyst and if indicated, followed by a single frozen embryo transfer derived from donor eggs.
DOING WHAT IS BEST FOR OUR PATIENTS SINCE 1988 - David G. Diaz, MD
Let's help patients clarify the commonly held misinformation that twins is the goal of undergoing IVF and to educate them about maternal risks and long term fetal complications.