The dilemma faced by patients who undergo single embryo transfer
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ORIGINAL ARTICLE
The dilemma faced by patients who undergo single embryo transfer Rikikazu Sugiyama Æ Koji Nakagawa Æ Yayoi Nishi Æ Rie Sugiyama Æ Kei Ezaki Æ Masato Inoue
Received: 8 August 2008 / Accepted: 11 November 2008 / Published online: 26 December 2008 Ó Japan Society for Reproductive Medicine 2008
Abstract Purpose The aim of this study was to identify the factors that contribute to the decision to choose single embryo transfer (SET). Methods Two hundred and nine patients who underwent ART treatment in our clinics between April 2006 and May 2007 were enrolled in this study. All patients had elected to undergo SET before the start of each treatment cycle; a questionnaire was administered to all patients prior to the SET procedure. Results The mean age of the patients was 34.6 years old (range: 24–45 years). The mean number of redundant embryos was 3.7 (range: 1–17), and the pregnancy rate per embryo transfer was 25.7%. A total of 121 patients (57.9%) who underwent SET returned their questionnaires. Based on the results of questionnaire, 56.2% of patients who received SET waived their right to choose between single and double embryo transfer. Among patients who selected SET, 67.6% believed that the pregnancy rate resulting from double embryo transfer (DET) is significantly greater than that associated with SET, and 25% of patients wanted to have twins. The majority of patients (80.9%) who underwent SET understood that multi-fetal pregnancy increases the risk of complications during gestation and delivery. Among all patients who completed the questionnaire, 72.8% believed that the number of transferred embryos should not be controlled by law. Conclusions The results of the present study show that greater than one-half of patients who underwent SET were
R. Sugiyama (&) K. Nakagawa Y. Nishi R. Sugiyama K. Ezaki M. Inoue Division of Reproductive Medicine, Sugiyama Clinic, 1-53-1, Ohara, Setagaya, Tokyo 156-0041, Japan e-mail: [email protected]
faced with a dilemma––the difficult choice between their own desires and their clinician’s recommendation. Keywords Assisted reproductive technology (ART) Double embryo transfer (DET) Questionnaire Single embryo transfer (SET)
Introduction During the past two decades, the number of embryos transferred during assisted reproductive technology (ART) treatment has increased to produce a satisfactory pregnancy rate [1, 2]. Consequently, the number of multi-fetal pregnancies has increased, resulting in an elevated frequency of maternal and neonatal complications. As a result, reduction in the number of transferred embryos has been suggested as a way to reduce the incidence of multifetal pregnancy during the past decade. The first report of elective single embryo transfer (SET), which was published in 1999, demonstrated that, under select conditions, the pregnancy rate resulting from single embryo transfer was similar to that obtained using double embryo transfer (DET) [3]. Recently, resulted of a randomized multicenter trial indicated that the live birth ra
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