A mandatory single blastocyst transfer policy with educational campaign in a United States IVF program reduces multiple gestation rates without sacrificing pregnancy rates

Abstract

Objective: To reduce the twin rate in our IVF program. Design: A prospective educational study of infertile couples; a retrospective review of IVF outcomes before vs. after mandatory single embryo transfer (mSBT) policy change. Setting: University-based infertility center. Patient(s): One hundred ten of 120 consecutive new infertile couples completed the educational study. Outcomes of all embryo transfers (n = 693) performed 17 months before and 17 months after mSBT were evaluated. Intervention(s): A 1-page educational summary of comparative risks of twins vs. singletons to maternal and child health. Main Outcome Measure(s): Knowledge of twin risks and desired number of embryos transfered before and after education. Pregnancy rates, number of embryos transfered, and multiple-gestation rates before and after mSBT policy. Result(s): After education, knowledge of twin risks improved and a significant number of subjects changed their desired outcome to a lower gestational number. There was no change in ongoing pregnancy rates with blastocyst transfer before and after mSBT (63% vs. 58%; NS). Program-wide number of embryos transfered (2.1 ± 0.6 vs. 1.9 ± 0.7) and multiple-gestation rates (35% vs. 19%) decreased significantly while pregnancy rates were maintained. Conclusion(s): Simple educational materials can improve knowledge of twin pregnancy risks and affect decision making. In high-risk patients, mSBT results in pregnancy rates similar to two-blastocyst transfer, with decreased twin rates. © 2007 American Society for Reproductive Medicine.