Elective Single Embryo Transfer (eSET)

What is single embryo transfer?

Transfer of a single embryo  usually blastocyst at the time of  embryo transfer.

What is the advantage of single embryo transfer ?

The advantage of single embryo transfer is that it reduces multiple pregnancy.

What is the disadvantage of single embryo transfer?

The disadvantage of single embryo transfer is that it might reduce pregnancy rate per embryo transfer especially in older women and women with multiple IVF failure. It also increases the cost of treatment.

Who can benefit from a SET?

Couples who have good prognosis that means a young lady with good egg and sperm quality and good endometrium can benefit from SET.

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003416.pub5/full

What is the difference in the update of the single embryo transfer policy in different countries?

Funding is a very important factor.  Either you have government funding or you have private insurance funding or you pay out of your own pocket. So in countries where you’re paying out of your own pocket uptake of elective single embryo transfer is less. Nordic countries and UK have higher uptake of SET.

https://academic.oup.com/humupd/article/17/1/107/637987

What are the pre requirements of single embryo transfer ?

The IVF Lab should be sufficiently equipped to give high blastulation rate and should have an excellent cryo- preservation facility.

Should all patients have single embryo transfer ?

No we do not believe that all patients should have single embryo transfer. Women who are more than 35 and those who have multiple failed cycles can benefit from transferring more than one embryo.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991445/#:~:text=In%20our%20study%2C%2016.7%25%20out,of%20pregnancy%20are%20extremely%20low.

What caution must be exercised while interpreting data on internet ?

We must know that most of the data on internet on single embryo transfer is from the Western hemisphere. The prognosis of an Indian patient at 35 years is worse than the counterpart Caucasian lady. So we cannot just take foreign data and implement it into our Indian practice. We must have more solid Indian data before we propagate such strategies.