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Education May Overcome Patient Resistance to Single Embryo Transfer


 

MONTREAL — Patient resistance to having a single embryo transferred after in vitro fertilization may be overcome by education, according to Christopher Newton, Ph.D.

Patient goals in requesting multiple embryo transfer may be quite different, however, so their educational needs may vary. Some patients are focused on simply increasing their chances of conceiving. “They think more is better in terms of getting pregnant,” Dr. Newton, a psychologist at London (Ontario) Health Sciences Center, said in an interview.

But there is also a subset of patients who would prefer a twin pregnancy to a singleton one, he reported at the joint annual meeting of the American Society for Reproductive Medicine and the Canadian Fertility and Andrology Society.

Dr. Newton surveyed 79 female IVF patients and 53 male partners about their attitudes toward single embryo transfer (SET). He found that 75% of participants rated double embryo transfer (DET) as highly desirable, and 72% rated a twin pregnancy as highly desirable.

Some participants preferred DET to SET because they saw it as a means to increase their chances of pregnancy; others considered DET as a way of optimizing their chance of conceiving twins.

When provided with accurate information about the risks associated with twin pregnancies and the success rates of SET versus DET, the participants' desire for twins decreased and they reported more acceptance of SET. However, women remained more resistant to SET than men.

A separate study presented at the meeting found that infertile women are twice as likely as fertile women to prefer a multiple pregnancy over a singleton pregnancy.

A comparison of 440 general gynecology patients (fertile) with 464 infertility patients found that 20% of the latter expressed a desire for a multiple pregnancy, compared with 10% of the fertile group, reported lead investigator Ginny L. Ryan, M.D., of the University of Iowa, Iowa City.

In the combined population, a lack of knowledge about the risks of a multiple pregnancy along with nulliparity and a diagnosis of infertility independently predicted a desire for multiples.

“We've now started an educational campaign to see if we're impacting their knowledge,” Dr. Ryan said in an interview.

“We started a mandatory single embryo transfer policy in our best responders last year, so we're in a luxurious position where we can actually tell our patients that this isn't going to decrease their pregnancy rate and it will greatly decrease their multiple rate.”

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