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e-SET in IVF

January 21, 2015 by Dr. Demián Glujovsky
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Many years ago, four, five or more embryos were transferred simultaneously. And therefore, we known about the quintuplets that appeared on TV. However,  we are unaware of those pregnancies that either were arrested or ended as premature births due to multiple pregnancies. These cases do not usually become famous. The most important reason why so many embryos were transferred is that treatment effectiveness was very low.\nA decade ago, it was still common to transfer 3 embryos simultaneously. Embryo laboratories were much improved and, therefore, we didn’t need to transfer so many. Still, it was not ideal.

In recent years, most serious IVF programs transfer only two embryos simultaneously. Moreover, in many cases, we do elective single embryo transfers, especially if we transfer at blastocyst stage and, even more, if they are euploid after a PGS. Why?

  1. Because implantation rates increased substantially in recent years
  2. Because vitrification as embryo cryopreservation method works extremely well
  3. Because we can get to blastocyst stage much more than before. At a good embryo lab, the embryo that does not reach the blastocyst stage is because it is not viable. And the rate of blastocyst implantation is very high.
  4. Because if we have a blastocyst that after PGS we know that is chromosomally normal, the effectiveness is much higher.
  5. Because multiple pregnancies are associated with increased maternal and perinatal mortality. And they are also associated with severe complications during pregnancy and the neonatal period.
  6. Because while transferring two simultaneous embryos has a higher pregnancy rate than transferring one, the addition of transferring one fresh and one frozen embryo offers similar rates to transfer the two together. But the advantage of doing so sequentially, is maintaining the same chance of success with lower complication rates.
  7. And because without PGS, the transfer of 2 blastocysts have similar live births rate than transferring one euploid embryo after PGS.

In 2010, a systematic review published in BMJ by McLernon et al showed that transferring two embryos together had double chances of a live birth than a single embryo transfer, as well as 25 times more chances of a multiple pregnancy (and its potential complications, including five times more of preterm delivery). However, the same study showed no significant differences in live birth rates when comparing double transfer versus the transfer of a single fresh embryo and an ulterior frozen embryo transfer.

We, physicians, should help patients to consider all the variables that come into play with assisted reproduction treatments. This means, adequately explain the chances of success and complications. In a top level fertility center, the transfer of a an elective single embryo transfer is more and more used.

Contact Us

Dr. Demián Glujovsky in CEGYR Buenos Aires
Viamonte 1432 - Buenos Aires Argentina
info@fertilityargentina.com

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