What is elective single embryo transfer (eSET)?

An elective single embryo transfer is the option of selecting one embryo from a larger set of potentially viable embryos that are available and implanting the same into the uterus. The embryo thus chosen might be a fresh one or may have been frozen from a previous cycle of IVF. One of the biggest advantages of opting for an eSET is that it protects multiple conceptions and associated complications.

With advancing technologies and better identification of embryo growth, it is now becoming increasingly common and advantageous for patients to opt for a single embryo transfer and take out the possibility of multiple births. Also, an elective single embryo transfer has evidenced to be more effective and results in a higher percentage of healthy, normal pregnancies.

Is eSET appropriate for me?

While overall, it has been a successful method of inducing pregnancy and many patients have successfully delivered babies by elective single embryo transfer, the actual efficacy and possibility for an individual are based on a wide variety of factors. Broadly, it is agreed that it is an effective method for those below the age of 35 and with good quality eggs. In addition to these two criteria, the doctors will conduct a complete check of the patient, her history, possible complications before arriving at this decision.

What are the risks associated with multiple births?

Multiple births present various risks for both the mother and the baby. Some higher propensity to premature births to lower birth weight potential – multiple births have an inherent risk whether pregnancies are naturally or assisted. In many cases, this results in the need for specialized and acute medical care immediately following the birth of the little ones, and this might be the precursor for a lifetime of developmental challenges and the necessity of care.
For the mothers, multiple births mean a higher risk of labor and delivery-related complications. There is a higher propensity for c-sections in multiple births – which means a possibility of hemorrhage during delivery and a longer post-partum recovery for the mother.

Finally, there is a risk of mortality in multiple births. In many cases, it has been observed that multiple pregnancies could lead to mortality of one or more of the fetuses. Also, complications increase with the increasing age of the patient. It is ideal if those above the age of 35 completely avoid multiple births altogether.

How do I decide if eSET is for me?

The decision to opt for an elective single embryo transfer is both personal as well as clinical. It is important to have an open and comprehensive discussion with your fertility expert before arriving at this decision. There are of course pros and cons, and these must be adequately weighed-in before any decision is made.

Being open to all possibilities is a good start. If you have already made up your mind one way or the other, then it could be a cause of disappointment, should your preferred option be unavailable or unviable in your case.

It is also important to keep in mind that certain biological conditions may make it difficult for you to opt for the single elective embryo transfer – these include being over the age of 35, not having the adequate quality of eggs, hormonal issues, amongst others.

Also, consider the fact that multiple pregnancies are a distinct possibility with multiple embryo transfers – are you okay with the risk, would you be able to handle multiple births, and do you have the support system available should you have multiple babies as a result? These are some of the factors to consider before going against the eSET option.
Either way, as it is evident the decision boils down to both clinical as well as personal considerations. Evaluating each of these comprehensively is the best way to determine whether you can go for an eSET or not.