Single Embryo Transfer Policies Decrease Perinatal Mortality Rates

The policy of single embryo transfer for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) procedures has decreased the perinatal mortality rate, says a study presented at the annual meeting of the European Society of Human Reproduction and Embryology held in Istanbul between July 1 and July 4, 2012.

Perinatal deaths are defined as fetal deaths (stillbirths) and neonatal deaths that occur before 28 days after birth. A policy of single embryo transfer versus double embryo transfer appears to have reduced the number of perinatal deaths among IVF and ICSI babies.

According to the study led by Professor Elizabeth Sullivan from the Perinatal & Reproductive Epidemiology Research Unit of the University of New South Wales in Sydney, Australia, the total perinatal mortality rate was 16.2 per 1,000 births. However, the death rate following double embryo transfer was significantly higher than the death rate following single embryo transfer.

Single embryo transfer resulted in 13.2 deaths per 1,000 births. Double embryo transfer resulted in 19.1 deaths per 1,000 births.

Based on these findings, Sullivan commented in a statement reported on Doctors Lounge:

“There is justification for advocating SET [single embryo transfer] as first-line management in assisted reproduction, with the aim of minimizing preventable perinatal deaths.”

Because twins accounted for half of the total neonatal deaths and one-third of the perinatal deaths, minimizing the possibility of twins is one way in which single embryo transfer reduces the perinatal mortality rate.

As reported by Science Daily, Sullivan further explains:

“The number of embryos transferred per procedure is the major determinant of multiple pregnancy and multiple delivery, which contribute to an elevated risk of preterm birth and low birth weight, and its sequelae. These are risks in addition to those already faced by women being treated for infertility.”

She also adds:

“Australia and New Zealand have shown that in the right policy environment a voluntary change to SET practice is achievable. In some other countries and regions,” said Professor Sullivan, “the uptake of SET has been more dramatic, particularly where policy initiatives linked to funding have led to significant change in practice without compromising quality or safety.”

Do you agree with a single embryo transfer policy for IVF and ICSI?