eSET irrespective of the availability of a good-quality embryo in the first cycle only is not effective in reducing overall twin pregnancy rates

Aafke P. A. van Montfoort*, Audrey A. A. Fiddelers, Jolande A. Land, Carmen D. Dirksen, Johan L. Severens, Joep P. M. Geraedts, Johannes L. H. Evers, John C. M. Dumoulin

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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INTRODUCTION: In several clinics, elective single-embryo transfer (eSET) is applied in a selected group of patients based on age and the availability of a good-quality embryo. Whether or not eSET can be applied irrespective of the presence of a good-quality embryo in the first cycle, to further reduce the twin pregnancy rate, remains to be elucidated. METHODS: In patients <38 years two transfer strategies were compared, which differed in the first cycle only: group A (n = 141) received eSET irrespective of the availability of a good-quality embryo, and group B (n = 174) received eSET when a good-quality embryo was available while otherwise they received double embryo transfer (DET; referred to as eSET/DET transfer policy). In any subsequent cycle, in both groups the eSET/DET transfer policy was applied. RESULTS: After completion of their IVF treatment (including a maximum of three fresh cycles and the transfer of frozen-thawed embryos), comparable cumulative live birth rates (62.4% in group A and 62.6% in group B) and twin pregnancy rates (10.1 versus 13.4%) were found. However, patients in group A required significantly more fresh (2.0 versus 1.8) and frozen (0.8 versus 0.5) cycles. CONCLUSIONS: The transfer of one embryo in the first cycle, irrespective of the availablity of a good-quality embryo, in all patients <38 years, is not an effective transfer policy for reducing the overall twin pregnancy rate.

Original languageEnglish
Pages (from-to)1669-1674
Number of pages6
JournalHuman Reproduction
Issue number6
Publication statusPublished - Jun-2007
Externally publishedYes


  • assisted reproductive technologies
  • multiple pregnancy
  • single-embryo transfer
  • IVF

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