Towards single embryo transfer? Modelling clinical outcomes of potential treatment choices using multiple data sources: predictive models and patient perspectives

Abstract

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Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon

“…Roberts et al 47 found that DET produced a higher expected live birth rate than eSET (30.8% versus 27.8%) when success rates for frozen embryos matched those observed in their clinical data set, but their analysis suggested that eSET might outperform DET if outcomes following frozen embryo transfer were to improve.…”

“…A recent study 47 simulated cumulative outcomes from a single complete cycle with eSET (with frozen embryos thawed one at a time) and a single complete cycle with DET (with frozen embryos thawed two at time), using statistical models developed from a large observational data set. Roberts et al 47 found that DET produced a higher expected live birth rate than eSET (30.8% versus 27.8%) when success rates for frozen embryos matched those observed in their clinical data set, but their analysis suggested that eSET might outperform DET if outcomes following frozen embryo transfer were to improve.…”

Elective Single Embryo Transfer: an update to UK Best Practice Guidelines

“…Interviews and focus groups conducted with patients undertaking fertility treatment continue to indicate a clear patient preference for twins despite the potential to maintain overall lbr with an eSet strategy (leese & Denton, 2010;roberts et al, 2010b). It is therefore vital when considering eSet that clinics ensure the needs of patients are taken into account and that patient preference is not seen as irrational.…”

“…a review of patients' views on eSet was carried out by Denton (2010), androberts et al (2010b) presented further research into uK patient perspectives. many patients perceive patient selection (be it mandatory or voluntary) included in an Set programme as unfair and view the risk of twins from Det as acceptable within the boundaries of their own personal circumstances.…”

Increasing Pregnancy by Improving Embryo Transfer Techniques

“…From a societal perspective, these studies show that savings in health costs related to twin pregnancies may equal the direct additional costs of the repeat SET cycles needed to achieve the same take-home baby rate. In many cases, the direct costs of treatment are the responsibility of the patients, whereas the costs related to multiple pregnancies are imposed on both patients and the government (Roberts et al, 2010). Finally, a more cost-effective and safer procedure may be offered by elective single embryo transfer for patients who undergo assisted reproductive technology.…”