Elective Single Embryo Transfer (eSET): is it right for you?

The choice to transfer one embryo during an IVF cycle, rather than the two or three so commonly suggested in fertility clinics, is all the rage in our community right now.  Maybe it is a reaction to media stories that can imply that multiples (twins, triplets, etc) are in some way a desirable outcome.  Perhaps we’re just as horrified as anyone about what some of our colleagues are doing.

Regardless, many of us are talking about eSET.

After all, multiples are usually not a best-case scenario.  This British site enumerates risks and the ASRM voices similar concerns.

Moreover, elective single embryo transfer could “benefit everyone” when we only consider dollars and cents.

But these benefits come at a steep price: eSET is associated with lower pregnancy rates….as much as 38% lower according to this recent analysis of 1354 patients.

Are significantly lower rates really appropriate for patients undergoing these expensive and invasive treatments?  Well, maybe…particularly if the main beneficiaries would be willing to help with the cycle.  Government funding is available in many Western countries.   We hope to see it one day soon across Canada, not only in Quebec, but every province in our country.  (Ontario might be next).

For the moment, government funding for IVF is not available to most Canadians.  Until it is, I’m going to encourage my patients to do what is best for them.  And for many, that will continue to mean transferring more than one embryo.  We will have some twins, and we will have many more patients who are simply…..pregnant.  Within the realities of our current system, I believe that I am offering the best–the most moral and most effective– treatment possible.

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