僅年青子宮卵巢正常適合單一胚胎植入

僅有年青，子宮正常，卵巢正常無老化，胚胎卵子數量品質普遍優良的病患，可施與單一胚

胎植入sET

http://humrep.oxfordjournals.org/content/21/6/1337.full

The relative myth of elective single embryo transfer

1. Norbert Gleicher ¹ , ² , ³ , ⁵ and 
2. David Barad ¹ , ² , ⁴

+Author Affiliations

1. ¹Center for Human Reproduction, New York, NY, ²Foundation for Reproductive Medicine, ³Department of Obstetrics and Gynecology, Yale University School of Medicine, Chicago, IL and ⁴Department of Epidemiology and Social Medicine and Department of Obstetrics and Obstetrics and Gynecology & Women’s Health, Albert Einstein College of Medicine, Bronx, NY, USA

1. 5To whom correspondence should be addressed at: Center for Human Reproduction, 21 East 69th Street, New York, NY 10021, USA. E-mail: ngleicher@thechr.com

• Received October 31, 2005.
• Revision received January 6, 2006.
• Accepted January 13, 2006.

 

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Abstract

The option of single embryo transfer (SET) has recently dominated the pages of this and other medical journals. Opinions, in regards to the utility of such an approach, appear to differ between Europe and the US. While US guidelines promote a more individualized approach, European opinions, at times, even advocate mandated practice patterns. The European approach, however, fails to recognize the rather significant differences in supportive arguments between the historical switch from multiple embryo transfers to 2-embryo transfers and the current discussion, favouring a switch from 2-embryo transfer to elective (e)-SET. In the former, a significant risk of (at times, high-order) multiple pregnancies was reduced without loss of pregnancy potential. In the latter, a comparably relatively low twinning risk is reduced at the expense of declining pregnancy rates, a need for more treatment cycles, a potential delay in treatment success and, potentially, higher treatment costs. These consequences of e-SET, together with the preference of some infertility patients to actually conceive twins, raise serious questions about the wide utilization of e-SET, as has been propagated by many authorities. According to US guidelines, e-SET, therefore, appears to represent an appropriate transfer option for only a small minority of IVF patients. Argument in favour of indiscriminate SET appears unrealistic and should be reconsidered.