Elective Single Embryo Transfer (eSET)

Elective single embryo transfer – eSET – is when a woman undergoing in vitro fertilization (IVF) makes a choice to have only one embryo transferred to her uterus in place of multiple embryos.

Advantages of Elective Single Embryo Transfer

Improvements in the technology and techniques of IVF have led to higher implantation rates, elevating the risk of multiple births. According to the American Society of Reproductive Medicine, approximately 30 percent of IVF procedures today result in multiple births, making elective single embryo transfer an attractive option for some couples.

Most women who choose elective single embryo transfer do so to avoid the risk of multiple gestation pregnancy. Women carrying multiples are more likely to suffer miscarriage and other maternal pregnancy complications. Babies who are multiples are at higher risk for premature birth and fetal abnormalities.

Elective single embryo transfer allows the healthiest, most viable embryo to be transferred, increasing the chances of a successful pregnancy. Embryos are selected based on the morphologic evaluation. Although the selection process is not foolproof, new techniques – such as embryonic genetic screening – are currently being studied.

Patients who are Good Candidates for eSET

Elective single embryo transfer is a good option for some women, but reproductive endocrinologists do not recommended it in all cases. Women considered top candidates for eSET include the following:

• Those younger than 35 years of age
• Women undergoing their first assisted reproductive technology (ART) cycle
• Those with a relatively high number of good quality embryos
• A woman with additional quality embryos available for cryopreservation

Success Rates of Elective Single Embryo Transfer

For women who are appropriate candidates, success rates of elective single embryo transfer are high. Overall pregnancy rates may decline when eSET is used for less than ideal patients, such as those over age 35. To improve elective single embryo transfer rates, fertility specialists recommend freezing quality embryos for later transfer.

Women and couples considering eSET should talk with their reproductive endocrinologist about the procedure and whether or not it is a good option for them.