A study conducted in Ontario, Canada, has revealed a marked decline in multifetal pregnancy rates following the implementation of an elective single-embryo transfer (eSET) policy in 2015 as part of the publicly funded fertility program. This policy change has been associated with a considerable decrease in multifetal pregnancy rates, as reported in a recent study.
According to lead author Maria Velez, MD, PhD, from Queen’s University in Kingston, Ontario, the primary goal of the Ontario fertility program was to ensure equitable access to fertility treatment while also striving to reduce multifetal pregnancy rates by advocating for the transfer of a single embryo at a time.
Multifetal pregnancies, particularly those resulting from assisted reproductive technologies (ARTs) such as in vitro fertilization (IVF) and ovulation induction or intrauterine insemination (OI/IUI), pose significant risks to maternal health and can lead to adverse outcomes such as preterm birth. The study aimed to analyze the impact of the eSET policy on multifetal pregnancy rates and compare outcomes before and after its implementation.
Analyzing data from over 1.7 million pregnancies spanning from April 2006 to March 2021, researchers observed a substantial decrease in multifetal pregnancy rates following IVF and OI/IUI procedures. Specifically, multifetal pregnancy rates decreased from 29.4% to 7.1% after IVF and from 12.9% to 9.1% after OI/IUI. Additionally, twin pregnancy rates also showed a decline, further emphasizing the impact of the eSET policy on reducing multiple pregnancies.
Dr. Velez highlighted the importance of these findings in promoting safer fertility treatments and improving maternal and fetal outcomes. She emphasized the need for continued efforts to optimize ART practices and ensure that policies promoting single-embryo transfer are effectively implemented.
Commenting on the study, Sarka Lisonkova, MD, PhD, from The University of British Columbia, underscored the significance of publicly funded fertility programs in providing equitable access to IVF treatments while also addressing concerns about multifetal pregnancies. Dr. Lisonkova emphasized the role of eSET policies in enhancing the likelihood of successful pregnancies and reducing the risks associated with multiple pregnancies.
The findings of this study contribute valuable insights into the impact of eSET policies on multifetal pregnancy rates, highlighting the importance of evidence-based approaches in reproductive healthcare policy and practice. As ART practices continue to evolve, policymakers and healthcare providers must consider strategies to optimize outcomes and ensure the safety of assisted reproduction procedures.
