The United States falls behind parts of the world such as, Europe and Australia, when it comes to taking steps to reduce the incidence of multiple pregnancies associated with assisted reproductive treatment (ART). It is widely held in the USA that elective-Single Embryo Transfer (e-SET) cycles will not hold the same chance for live birth as multiple embryo transfer cycles. The literature originating from countries that provide significant funding towards ART treatment challenges this widely held belief.
Should we bother trying to reduce the incidence of multiple pregnancies? The short answer is “absolutely yes”. There are an overwhelming number of studies from the USA and around the world that document the burden and risk of multiple pregnancies to the developing infants, the woman carrying the multiple pregnancies and to the family into which multiple newborns are raised. In the past we have concentrated our effort to reduce high order multiple pregnancies, triplets and quadruplets. However the consequences of twin pregnancies remain a significant burden in the USA today.
Certain patient characteristics make them more vulnerable to developing a twin or higher order multiple pregnancies. These characteristics include: the female partner being under thirty-five years old; having one or more highest quality blastocyst on day five of embryo development; the use of donor oocytes and the presence of one or more highest quality blastocyst on day five that have been shown to have normal chromosome count (by PGD-AS) regardless of the age of the female partner.
The fertility specialists at SCRC have the highest percentage of e-SET treatment cycles in Southern California and indeed are amongst the leaders in the nation as a whole. Not only has the introduction of e-SET reduced the incidence of multiple pregnancies in those patients at highest risk but has done so with stunning pregnancy (82%) and live birth (79%) rates. The data derived from this ongoing work was selected for oral presentation at the Pacific Coast Reproductive Society annual meeting in April 2008 and at the College of Reproductive Biology annual meeting in May 2008 by former ART Embryology Laboratory Supervisor, Christine Briton-Jones PhD.