The multiple benefits of single embryo transfers

The shift to single embryo transfer (SET), where only one embryo is transferred during assisted reproductive technology (ART) treatments such as IVF, has saved an estimated $47.6 million in birth-admission hospital costs alone, said Dr Georgina Chambers, a research fellow at the Perinatal and Reproductive Epidemiology Research Unit at the University of New South Wales, and co-authors.

SET cycles as a proportion of all embryo transfer cycles grew from 29.5% in 2002 to 67.7% in 2008 in Australia.

The transfer of multiple embryos used to be common practice as it offers women a higher chance of conceiving per treatment cycle. The downside is that it results in more multiple births, translating to significantly increased risks and greater hospital use by mothers and babies.

The researchers said Australia has been a world leader in reducing the incidence of ART multiple births, supported by government funding for ART treatment and a voluntary move by fertility clinics and their patients to opt for the safer SET practice.

The researchers said that, theoretically, the $47.6 million savings equated to 7042 ART treatment programs being funded and the births of 2841 babies.

“Fifty-five per cent of the increased use of ART services since 2002 has been theoretically funded by the fall in twin and triplet birth rates,” the researchers said. “Much of the growth in ART use in Australia has been theoretically cross-subsidised by the move to safer embryo transfer practices.”

In an editorial published in the same issue of the journal, Professor Robert Norman, a fertility specialist at FertilitySA and director of reproductive and periconceptual medicine at the University of Adelaide’s Robinson Institute, said the use of SET justified continued government funding,

He said the research showed that the reduction in multiple pregnancies partially covers the cost of increased IVF activity, and he noted that the researchers did not factor in the ongoing health benefits throughout life of singleton babies, so the savings are probably even greater.

“Medicare IVF funding for SET seems a good investment to benefit those with an excellent chance of success, while keeping complications for women and their babies to a minimum,” said Professor Norman.

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

CONTACTS:             Prof Robert Norman                                  0450 840 245

                             Dr Georgina Chambers                              0408 664 490