Mandatory single embryo transfer policy dramatically decreases multiple pregnancy rates

Aim: The aim of this study is to determine the effect of a mandatory single embryo transfer (SET) policy on pregnancy rates and multiple pregnancy rates in intracytoplasmic sperm injection (ICSI) cycles.

Methods: One hundred and twenty-eight patients (154 cycles) underwent ICSI before the Turkish Ministry of Health's legislation, 55 patients (69 cycles) underwent ICSI after the legislation (day-3 embryo transfers only) and 35 patients (39 cycles) who underwent ICSI after the legislation (day-5 embryo transfers only).

Results: Groups were comparable regarding the women's mean age and body mass index. The number of embryos transferred (2.7 ± 0.5 vs 1.0 ± 0.0 vs 1.0 ± 0.0) was significantly higher in group I, compared to group II and group III. Clinical pregnancy per embryo transfer (40.8% vs 15.1% vs 36.1%) and live birth rate (37.7% vs 13.2% vs 30.6%) were significantly lower in group II when compared to group I and group III. Multiple pregnancy rates (39.6% vs 0.0%, vs 0.0%) were significantly higher in group I when compared to group II and III. Implantation rates were significantly higher in group III when compared to group I and group II. Miscarriage rates were comparable among the groups.

Conclusion: The mandatory SET policy caused a dramatic decrease of multiple pregnancy rates. Mandatory SET with only day-3 embryo transfers decreased the pregnancy rates but this detrimental effect was not seen in cycles with day-5 embryo transfers.