Cumulative results including obstetrical and neonatal outcome of fresh and frozen-thawed cycles in elective single versus double fresh embryo transfers

ObjectiveTo assess the efficacy of elective single embryo transfer (e-SET) compared to a double embryo transfer (DET) in a selected population including obstetrical and neonatal outcome of fresh and frozen-thawed cycles.DesignProspective nonrandomized study.SettingDepartment of reproductive medicine.Patient(s)Elective single embryo transfer was proposed to women < 36 years with adequate ovarian function, in their first or second IVF or intracytoplasmic sperm injection (ICSI) attempt with ejaculated sperm, with at least 4 mature oocytes and 2 fertilized top quality embryos. Patients who refused e-SET had two top embryos transferred (DET group).Intervention(s)Medical management and IVF–ICSI.Main Outcome Measure(s)Cumulative delivery rate, twin delivery rate, obstetrical and neonatal outcome.Result(s)According to patients' decision, 53 women had an e-SET and 98 a DET. The cumulative delivery rate per patient was 54.7% in the e-SET group and 49.0% in the DET group (P > 0.05). Twin delivery rate was significantly different between the two groups (3.5% versus 37.5% respectively, P < 0.05). Neonatal outcome in twins resulting from IVF–ICSI was found to be poorer than in singletons, considering the mean gestational age, mode of delivery, birthweight, and risk of neonatal intensive care unit admission for the infants.Conclusion(s)In a selected population, the elective transfer of one embryo with high implantation potential helped to avoid twin pregnancies without decreasing delivery rate.