Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- 14A IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 14B IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 15A Single Embryo Transfer Should Be Performed in All IVF Cycles
- 15B Single-Embryo Transfer Should Be Performed in All IVF Cycles
- 16A The Freezing of All Embryos Should Be Used for All IVF Cycles
- 16B The Freezing of All Embryos Should Be Used for All IVF Cycles
- 17A Luteal-Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 17B Luteal Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 18A A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 18B A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 19A All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 19B All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 20A Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 20B Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 21A Infertile Patients with Endometriosis Benefit from Surgery
- 21B Infertile Patients with Endometriosis Benefit from Surgery
- 22A Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 22B Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 23A All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- 23B All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
15B - Single-Embryo Transfer Should Be Performed in All IVF Cycles
Against
from Section III - The Best Policy
Published online by Cambridge University Press: 25 November 2021
Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- 14A IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 14B IVF Should Be First-Line Treatment for Unexplained Infertility of Two Years Duration
- 15A Single Embryo Transfer Should Be Performed in All IVF Cycles
- 15B Single-Embryo Transfer Should Be Performed in All IVF Cycles
- 16A The Freezing of All Embryos Should Be Used for All IVF Cycles
- 16B The Freezing of All Embryos Should Be Used for All IVF Cycles
- 17A Luteal-Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 17B Luteal Phase Support Should Be Stopped at the Time of a Positive Pregnancy Test
- 18A A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 18B A Natural Cycle Is the Best Protocol for Frozen Embryo Replacement
- 19A All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 19B All Pregnancies Conceived by IVF Should Be Delivered by Caesarean Section
- 20A Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 20B Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer
- 21A Infertile Patients with Endometriosis Benefit from Surgery
- 21B Infertile Patients with Endometriosis Benefit from Surgery
- 22A Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 22B Intramural Fibroids Greater than 4 cm in Diameter Should Be Removed to Aid Fertility
- 23A All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- 23B All Infertile Women with a Uterine Septum Should Have a Surgical Removal
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
Summary
Implementation of single embryo transfers in IVF has helped to reduce number of multiple pregnancies and the risks inherent with these conceptions. However, employing a blanket policy for all patients to have a single embryo transfer is inappropriate. In those with good prognosis single embryo transfers should be common practice, however those with a poorer prognosis may benefit from a double embryo transfer, such as those with advanced maternal age and recurrent implantation failure. Denying patients this option can be detrimental to their success rates, going against their patient autonomy and could be deemed unethical. There is conflicting evidence regarding cost-effectiveness between double embryo transfer and single embryo transfer and further studies are required to evaluate the true cost-effectiveness. A shared decision-making approach needs to be employed between Clinicians and patients, with both sides taking responsibility. With the question for debate being, should we consider multiple pregnancies an adverse outcome?
- Type
- Chapter
- Information
- 50 Big Debates in Reproductive Medicine , pp. 82 - 83Publisher: Cambridge University PressPrint publication year: 2021
References
Adashi, EY, Gleicher, N. Is a blanket elective single embryo transfer policy defensible? Rambam Maimonides Med J. 2017;8(2).CrossRefGoogle ScholarPubMed
Cutting, R. Single embryo transfer for all. Best Pract Res Clin Obstet Gynaecol. 2018;53:30–7.CrossRefGoogle ScholarPubMed
Wilkinson, D, Schaefer, GO, Tremellen, K, et al. Double trouble: should double embryo transfer be banned? Theor Med Bioeth. 2015;36(2):121–39.CrossRefGoogle ScholarPubMed
Ezugwu, E, der Burg, SV. Debating elective single embryo transfer after in vitro fertilization: a plea for a context-sensitive approach. Ann Med Health Sci Res. 2015;5(1):1–7.CrossRefGoogle ScholarPubMed
Tannus, S, Son, WY, Dahan, MH. Elective single blastocyst transfer in advanced maternal age. J Assist Reprod Genet. 2017;34(6):741–8.CrossRefGoogle ScholarPubMed