Single Embryo Transfer (SET) In IVF
Single Embryo Transfer Vs. Multiple Embryo Transfer
At IRMS our goal is to help our patients achieve a healthy pregnancy and live birth. Data supports that having one baby at a time creates the very best outcomes for both mother and child. Sometimes patients think that having twins is a desired outcome of ART but in reality, twins or other high-order multiples increase the risks for both mother and child. Twins and multiples are often delivered prematurely and mothers have a higher risk of preeclampsia, miscarriage, gestational diabetes as well as other pregnancy complications. Twins and other multiples account for a significantly increased percentage of NICU (neonatal intensive care unit) admissions. The likelihood of neonatal mortality had been shown to increase seven-fold for twins over singleton pregnancies. Additionally, the risk of severe physical impairments and cognitive delays has been shown to increase by 1.7-fold in twin pregnancies.
For these reasons, ASRM (American Society for Reproductive Medicine) is now recommending single embryo transfer in women under 40 undergoing blastocyst transfers, all women using donor eggs and all of those transferring embryos predicted to be normal after undergoing PGT (Preimplantation Genetic Testing-PGT-A or PGT-D).
PGT-A tests for aneuploidy, for example chromosome abnormalities such as missing or extra chromosomes (i.e. Trisomy 15; chromosome complement 47 XX or XY with an extra chromosome 15 which usually leads to miscarriage).
PGT-M tests for a gene on a chromosome causing a disease such as cystic fibrosis or sickle cell disease.
How Single Embryo Transfer Has Revolutionized IVF?
IRMS has been a leader in Single Embryo Transfer, reducing the number of multiple births while still resulting in extremely high pregnancy rates.
SET, along with the genetic testing of embryos (PGT), has revolutionized IVF because IRMS physicians are now able to choose the embryo that is most likely to result in a live birth. The statistics show us that the live birth rate hovers around 70–75% for women using IVF regardless of age, as long as the embryo is chromosomally normal.
Women with multiple miscarriages or problems getting pregnant due to their age, with the help of IVF, are highly likely to get pregnant as long as at least one of their embryos is normal. SET has minimized the monetary and emotional burden of having multiples.
The psychological impact of multiples on a couple’s relationship compared to singletons has not been well studied. However, a previous study by the Twin and Multiples Birth Association (TAMBA) has shown higher rates of divorce compared to their singleton counterparts. The rate of postpartum depression also appears to be higher for mothers of multiples. The use of SET combined with preimplantation genetic screening has decreased this potential burden for couples seeking children while maximizing their chances of a healthy live birth.