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Article
Five-years of a mandatory single-embryo transfer (mSET) policy dramatically reduces twinning rate without lowering pregnancy rates
Fertility and sterility
  • J. D. Kresowik
  • B. J. Stegmann
  • Amy E.T. Sparks, University of Iowa
  • Ginny L. Ryan, University of Iowa
  • Bradley J. Van Voorhis, University of Iowa
Document Type
Article
Peer Reviewed
1
Publication Date
12-1-2011
NLM Title Abbreviation
Fertil Steril
PubMed ID
21962964
DOI of Published Version
10.1016/j.fertnstert.2011.09.007
Abstract

OBJECTIVE: To report the outcomes of a program policy instituted in 2004 mandating single-embryo transfer (mSET) for all women aged <38 >years, with at least seven zygotes, no prior failed fresh cycle at our center, and at least one good-quality blastocyst. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PATIENT(S): All women 1, 1999, to May 31, 2004 (before mSET) and from June 1, 2004, to May 31, 2009 (after mSET). INTERVENTION(S): mSET policy implementation. MAIN OUTCOME MEASURE(S): Live-birth rate, multiple pregnancy rate, clinical volume, and outcomes of all mSET fresh IVF transfers were analyzed. RESULT(S): Clinical volume was unchanged between the two time groups. After implementation of mSET, live-birth rates improved from 51.1% to 55.9% and multiple-birth rates dropped from 34.8% to 17.5%. A total of 364 mSET fresh transfers were performed with a live-birth rate of 64.6% and a multiple-birth rate of 3.4%. CONCLUSION(S): A mandatory SET policy based on prognostic factors can be instituted with no drop in clinical volume and no negative effect on delivery rates. Multiple gestation rates can be dramatically lowered.

Keywords
  • Adult,
  • Down-Regulation,
  • Female,
  • Fertilization in Vitro/legislation & jurisprudence,
  • Guideline Adherence,
  • Health Plan Implementation,
  • Humans,
  • Mandatory Programs/legislation & jurisprudence,
  • Pregnancy,
  • Pregnancy Rate/trends,
  • Pregnancy,
  • Multiple/statistics & numerical data,
  • Single Embryo Transfer/statistics & numerical data/utilization,
  • Time Factors,
  • Twins/statistics & numerical data
Published Article/Book Citation

Fertility and sterility, 96:6 (2011) pp.1367-1369.

Citation Information
J. D. Kresowik, B. J. Stegmann, Amy E.T. Sparks, Ginny L. Ryan, et al.. "Five-years of a mandatory single-embryo transfer (mSET) policy dramatically reduces twinning rate without lowering pregnancy rates" Fertility and sterility Vol. 96 Iss. 6 (2011) p. 1367 - 1369 ISSN: 1556-5653
Available at: http://works.bepress.com/ginny_ryan/9/