Elective Single Embryo Transfer eSET

Elective single embryo transfer (eSET) is a procedure used when a woman undergoes in vitro fertilization (IVF). This is a way to eliminate the risk of multiple pregnancies. Discuss this option with your fertility specialist.


What is in vitro fertilization?

When a woman has in vitro fertilization, she first takes medications to stimulate her ovaries to develop more than one egg at a time. The eggs are collected via an egg retrieval process and fertilized with sperm in the laboratory setting. Then, embryos develop and one or more of these embryos are placed back in the uterus.


Why only transfer one embryo?

The main goal of eSET is to decrease the chance of multiple pregnancy, which is associated with IVF. Around 30% of IVF pregnancies are twin pregnancies in the U.S., and an additional 4% result in triplet or higher pregnancy. When only one embryo is transferred, it eliminates the chance of twins, triplets, or quadruplets.


Why should I avoid having a multiple pregnancy?

Multiple pregnancy is dangerous for the mother and the fetuses. When more than one baby is in the womb, it can lead to a premature delivery. Additionally, multiples are associated with long-term lung and gastrointestinal problems, cerebral palsy, and premature death.


What other ways can I prevent or reduce the risk of multiple pregnancy with IVF?

In order to increase the chances of having a full-term delivery, the number of fetuses are decreased early in the pregnancy. The eSET procedure is not acceptable for all couples, but many choose this to decrease risks to the unborn babies.


Who is a candidate for elective single embryo transfer?

Our fertility specialist select only women with the best prognosis for pregnancy. Several factors contribute to a successful outcome with eSET. Those who are candidates for elective single embryo transfer are women who:

  • Are undergoing their first cycle of assisted reproductive technology (ART)
  • Are younger than 35 years of age
  • Had a successful pregnancy with a previous ART cycle
  • Have embryos available for freezing to use later (cryopreservation)


How does the fertility specialist choose the best embryo?

To select the highest-quality embryo for the single embryo transfer process, the embryologist will grade each embryo based on appearance. The assessment includes the size and number of cells, as well as the rate of cell development. While the grading systems vary from clinic to clinic, they are similar. No method, however, can reliably predict which embryo will survive and produce a live birth.


What is the success rate of elective single embryo transfer?

For women who meet the criteria as appropriate candidates, eSET has shown excellent pregnancy rates. Overall, there is only a slight decrease in pregnancy rates after the procedure. Women who are not good candidates for eSET, for instance, may not have as high of success rates as those who meet all the requirements. The fertility specialist often freezes extra embryos for transferring later on to increase the success rate. According to the Pacific Coast Reproductive Society, use of eSET has increased IVF pregnancy rates to 82%, and the live birth rate is around 79%.


What technology is used in eSET?

Elective single embryo transfer employs many approaches, which increase the chance of pregnancy. These include extended embryo culture, comprehensive chromosome screening, time-lapse photography, and vitrification (warming one embryo at a time after freezing).