Single Embryo Transfers Increase in '09


Infertility treatments performed in 2009 resulted in more than 56,000 live births, according to the latest data from the Society for Assisted Reproductive Technology.

In 2009, 367 clinics from around the United States reported data to SART on 142,241 treatment cycles, resulting in 56,778 live births. In vitro fertilization (IVF) made up more than 99% of the treatments performed that year.

The latest figures indicate that infertility specialists are continuing to transfer fewer embryos in each cycle. For example, the average number of fresh embryos transferred from nondonor oocytes was 2.1 among women under age 35 years, 2.3 among women aged 35-37 years, and 2.7 among women aged 38-40 years. These are similar to figures reported in 2008.

More women also are opting for single embryo transfer (SET). In 2009, 7.2% of cycles in women under age 35 years involved elective SET. In women aged 35-37 years, SET made up about 4% of cycles. Comparatively, in 2003, the percentage of cycles with elective SET in women under age 35 years was 0.7%, and that figure was 0.4% in women aged 35-37 years.

The trend toward transferring fewer embryos is encouraging, fertility experts agreed.

“The trends are going the right way,” said Dr. Zev Rosenwaks, director of the Center for Reproductive Medicine and Infertility at Weill Cornell Medical College and New York Presbyterian Hospital, New York. But while SET is the safest approach, it does result in a lower pregnancy rate. That can make it a tough sell with women, especially if they have tried IVF in the past and have been unsuccessful, he said.

Dr. Brad Van Voorhis, director of the IVF unit at the University of Iowa, Iowa City, said his clinic has made a point of encouraging patients to consider SET, and it has had success. A summary report for 2008 states that the percentage of cycles with elective SET at his clinic was 33.1% among women under age 35 years and 30% among women aged 35-37 years. Part of the solution is to educate women about the potential complications of multiple births. Generally, patients are more accepting if they understand the risks involved, he said. But the clinic doesn't leave the decision completely in the hands of patients. Dr. Van Voorhis and his colleagues tell patients up front that in cases where there is a good candidate and a high-quality embryo, they will only transfer a single embryo per cycle.

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