Amsterdam, 26 July 2011 - Elsevier announced the publication of several commentaries in the scientific journal Reproductive BioMedicine Online on the subject of how many embryos it is safe and proper to place in a uterus, and how best to regulate this decision. It is a dilemma faced by all patients anxiously caught between no pregnancies at all or facing the prospect of twins or triplets. In this difficult place it is often all too easy to think that the latter option must be the best. But is it?
The debate was sparked by a paper from Dr Francois Bissonnette et al., which describes the impact of the implementation of new legislation in Quebec, Canada, on the rates of multiple births and pregnancy. This legislation was introduced in August 2010 in conjunction with state-finance for assisted reproduction treatments. The aim was to reduce multiple pregnancies, described as "the major negative side effect of ART (Assisted Reproductive Technology), by controlling the number of embryos that could be transferred in any one cycle.
In the first three months of this programme, 1353 cycles of IVF were performed in the five Quebec-based ART centers. Single embryo transfers accounted for 50% of transfers compared with only 1.6% prior to legislation a big decline. The effect of this was to reduce the overall clinical pregnancy rate from 42% to 32% per transfer for the first time describing a diminishment of overall pregnancy results. Such an outcome is not unexpected, since embryologists cannot always predict the health of the embryos being transferred. In contrast, previous work from Scandinavia and Belgium has claimed that pregnancy rate is not affected (or only marginally so) when embryo numbers are reduced perhaps an unrealistic routine outcome? However, the multiple pregnancy rate was reduced from 25.6% to only 3.7%. It is suggested that having state-financed ART created an environment in which the mor
|Contact: Gedis Grudzinskas|