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.
- Fertilization in Vitro/legislation & jurisprudence,
- Guideline Adherence,
- Health Plan Implementation,
- Mandatory Programs/legislation & jurisprudence,
- Pregnancy Rate/trends,
- Multiple/statistics & numerical data,
- Single Embryo Transfer/statistics & numerical data/utilization,
- Time Factors,
- Twins/statistics & numerical data
Fertility and sterility, 96:6 (2011) pp.1367-1369.
Available at: http://works.bepress.com/ginny_ryan/9/