New strategy could reduce twin rate after IVF

September 30, 2010

A strategy to encourage single embryo transfer after in vitro fertilisation (IVF) could be an important tool to prevent multiple pregnancies and their associated complications, finds a study published on bmj.com today.

Deciding how many embryos should be transferred after IVF is a complex problem. The transfer of only one embryo will prevent a multiple pregnancy and the risk of complications for mother and baby, but could require more cycles to achieve pregnancy.

Although professionals and policy makers have launched initiatives to encourage the use of single embryo transfer, in 2004 it was used in only 19% of in vitro fertilisation cycles in Europe. The effect of patient empowerment on decision making is also still being debated.

So a team of researchers in the Netherlands set out to evaluate the effects of a multifaceted patient empowerment strategy aimed at helping couples decide how many embryos should be transferred after IVF.

The study involved 308 couples on the waiting list for a first IVF cycle at five clinics in the Netherlands. Couples were randomly selected to receive either the intervention strategy or standard IVF care.

The strategy consisted of a decision aid, support from an IVF nurse, and the offer of an extra IVF cycle if single embryo transfer was unsuccessful.

The results show that, after the first IVF cycle, 43% of couples in the intervention group chose single embryo transfer compared with 32% in the control group. After the second IVF cycle, single embryo transfer was used by 26% of couples in the intervention group compared with 16% in the control group.

Neither of these findings were statistically significant, which means that the results could be simply down to chance. And there were no differences between the couples' levels of anxiety or depression compared with those receiving standard care. However, couples receiving the strategy had significantly higher empowerment and knowledge levels.

The average savings compared with standard IVF care were €169.75 (£146.77; $219.12) per couple. If these savings were extrapolated to the Dutch national level, with 7,500 new couples per year, this reduction would add up to €1,273,125 annually, say the authors.

It seems that patients are willing and able to make complex decisions, if they are empowered to do so, conclude the authors.

They add: "This study illustrates that a multifaceted empowerment strategy can effectively encourage the use of single embryo transfer in clinical IVF practice. The strategy increases patient knowledge and has no substantial effect on levels of anxiety or depression. The strategy reduces costs as well, and could therefore be an important tool to reduce the twin rate after in vitro fertilisation, within a setting with patient autonomy."

An accompanying editorial says that supporting patients with reliable information is key to empowerment.
-end-


BMJ

Related Embryo Articles from Brightsurf:

Cell diversity in the embryo
Epigenetic factors control the development of an organism.

Epigenetics: What the embryo can teach us about cell reprogramming
Cell reprogramming provides an outstanding opportunity for the artificial generation of stem cells for regenerative medicine approaches in the clinic.

New view on how tissues flow in the embryo
Watching and measuring what happens in tissues inside the human embryo is currently not possible, and it's difficult to do in mammalian models.

Unprecedented single-cell studies in virtual embryo
Researchers from the European Molecular Biology Laboratory (EMBL) in Heidelberg and from the University of Padua School of Medicine have created the first complete description of early embryo development, accounting for every single cell in the embryo.

Evaluating embryo quality with ultrasensitive protein detection
Infertility is estimated to affect 9% of reproductive-aged couples globally, and many couples turn to assisted reproductive technology.

Bovine embryo completely regenerates placenta-forming cells
A calf was born from an embryo lacking cells which form a large part of the placenta, providing new insight into the regenerative capacity of mammalian embryos.

Simulations suggest embryo selection based on traits like height or IQ is still far off
The recent live births resulting from human embryonic CRISPR editing have heightened global concerns regarding 'designer babies.' Currently, the most practical approach to genetic 'enhancement' is preimplantation genetic screening of IVF embryos.

Embryo's early development revealed in a dish
Rice University bioscientists develop a method to observe patterns of early embryonic development, during which ectodermal cells diverge toward their fates as skin, organs and the nervous system.

How neural circuits form in a developing embryo
A new imaging method follows young neurons in a developing embryo as they progress from a messy jumble of cells into a coordinated control center.

Do women regret embryo testing before IVF?
By the time a woman is 44 years old, the vast majority of her embryos will be abnormal.

Read More: Embryo News and Embryo Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.