Physicians and patients’ motivations to perform elective single or double-embryo transfers: A nationwide survey

Glujovsky, Demián; Sueldo, Carlos; Coscia, Andrea; Carvalho, Paula De; Lancuba, Stella; Martínez, Gustavo; Ciapponi, Agustín

doi:10.1016/j.pec.2017.12.010

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…Cross‐sectional studies would contribute to the understanding of patients’ attitudes, and it has been shown that the majority of both women and men undergoing IVF treatment do in fact prefer to have twins for various reasons, irrespective of medical risks. Hence, a general policy of SET might be in conflict with patient interests and wishes, and this knowledge has been suggested to be useful in everyday clinical practice when explaining the rationale for choosing SET as an option, as choosing something less effective as a minimum requires sufficient and objective information and discussion .…”

Section: Attitudes Knowledge and Health Behaviormentioning

confidence: 99%

“…From a health professional's point of view the main reasons for not offering elective SET have been shown to be the belief among doctors that patients prefer optimal pregnancy rates irrespective of the potential complications , and therefore the development of more formal decision‐aid tools has been advocated to help with counseling.…”

Section: Attitudes Knowledge and Health Behaviormentioning

confidence: 99%

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Cross‐sectional studies – what are they good for?

Kesmodel

2018

Acta Obstet Gynecol Scand

262

131

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Cross-sectional studies serve many purposes, and the cross-sectional design is the most relevant design when assessing the prevalence of disease, attitudes and knowledge among patients and health personnel, in validation studies comparing, for example, different measurement instruments, and in reliability studies. This paper describes the use of cross-sectional studies and provides examples within obstetrics and gynecology. Caveats are also described; for example, when cross-sectional data is used for analytical purposes of associations between an exposure and an outcome, authors and readers should be careful not to make causal inferences, unless the exposure may safely be assumed to be stable over time and not influenced by experiencing the outcome. In such cases, analyses are also subject to selection and information bias as well as confounding.

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Section: Attitudes Knowledge and Health Behaviormentioning

confidence: 99%

Section: Attitudes Knowledge and Health Behaviormentioning

confidence: 99%

Cross‐sectional studies – what are they good for?

Kesmodel

2018

Acta Obstet Gynecol Scand

262

131

View full text Add to dashboard Cite

show abstract

“…In addition, some patients were seeking twins and wished to minimize physical and psychological stress by having as few IVF treatments as possible [12]. Of course, many physicians or centers did not offer SET due to their pursuit of a successful rate in one transfer cycle [11,13]. For doctors or patients, weighing the safety and success rate of assisted reproductive technology may be a difficult task.…”

Section: Discussionmentioning

confidence: 99%

The clinical outcomes of selective and spontaneous fetal reduction of twins to a singleton pregnancy in the first trimester: a retrospective study of 10 years

Wang

Tang

Song

et al. 2022

Reprod Biol Endocrinol

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Background Singleton pregnancy is encouraged to reduce pregnancy complications. In addition to single embryo transfer (SET), selective and spontaneous fetal reduction (SEFR and SPFR) can also achieve singleton pregnancies. After SEFR or SPFR, an inanimate fetus remains in the uterus. It is unclear whether the inanimate fetus would adversely affect another fetus or the mother. Previous studies have focused on the differences between pre- and post-reduction. However, studies focusing on the influence of SEFR and SPFR on the remaining fetal development and maintenance of pregnancy are rare. Methods Materials from 5922 patients whose embryo transfer dates ranged from March 2011 to January 2021 were collected. Both the SEFR group (n = 390) and SPFR group (n = 865) had double embryos transferred (DET) and got twin pregnancies, but subsequent selective or spontaneous fetal reduction occurred. The SET group (n = 4667) had only one embryo transferred. All were singleton pregnancies on the 65th day after embryo transfer. Clinical outcomes, including pregnancy outcomes, pregnancy complications, and newborn outcomes, were compared among the three groups. Results After adjusting for age, infertility duration, types of infertility, states of embryos, body mass index, and factors affecting SET or DET decisions, multivariate regression analysis revealed that SEFR increased the risk of miscarriage (OR 2.368, 95% CI 1.423–3.939) and preterm birth (OR 1.515, 95% CI 1.114–2.060), and reduced the gestational age (βeta -0.342, 95% CI -0.544– -0.140). SPFR increased the risk of gestational diabetes mellitus (GDM) (OR 1.657, 95% CI 1.215–2.261), preterm premature rupture of membranes (PPROM) (OR 1.649, 95% CI 1.057–2.574), and abnormal amniotic fluid volume (OR 1.687, 95% CI 1.075–2.648). Both SEFR and SPFR were associated with reduced live birth rate (OR 0.522, 95% CI 0.330–0.825; OR 0.671, 95% CI 0.459–0.981), newborn birth weight (βeta -177.412, 95% CI -235.115–-119.709; βeta -42.165, 95% CI -83.104–-1.226) as well as an increased risk of low-birth-weight newborns (OR 2.222, 95% CI 1.490–3.313; OR 1.510, 95% CI 1.092–2.087). Conclusions DET with subsequent fetal reduction was related to poor clinical outcomes. We recommend that DET with subsequent fetal reduction should only be considered as a rescue method for multiple pregnancy patients with potential complications, and SET is more advisable.

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Why are multiple pregnancy rates and single embryo transfer rates so different globally, and what do we do about it?

Adamson

Norman

2020

Fertility and Sterility

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Physicians and patients’ motivations to perform elective single or double-embryo transfers: A nationwide survey

Cited by 3 publications

References 26 publications

Cross‐sectional studies – what are they good for?

Cross‐sectional studies – what are they good for?

The clinical outcomes of selective and spontaneous fetal reduction of twins to a singleton pregnancy in the first trimester: a retrospective study of 10 years

Why are multiple pregnancy rates and single embryo transfer rates so different globally, and what do we do about it?

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