Source: The National Post (Canada) – April 9, 2014
The Ontario government recently announced it would fund a single cycle of IVF for Ontario residents for all forms of infertility, and will set $85 million aside over a period of 3 years to fund IVF. In addition, they are creating an advisory board to ensure fertility centers follow best practices, including performing single embryo transfer (SET) for IVF cycles.
Reproductive endocrinologists define SET as placing one embryo in the uterus or fallopian tubes during a fresh or frozen/thaw IVF cycle.
Reproductive endocrinologists define SET as placing one embryo in the uterus or fallopian tubes during a fresh or frozen/thaw IVF cycle. While many fertility centers transfer multiple embryos to increase the chance of a successful pregnancy, multiple studies have shown similar live birth rates regardless of the amount of embryos transferred.
From Our Expert, Dr. Ronald Feinberg
“SET is a hallmark of RADfertility patient care”
This news is great for Ontario and reflects what we know at RADfertility—single embryo transfer (SET) offers the best chance for a healthy pregnancy. RADfertility has one of the highest proportions of SETs in the U.S., and SET is a driving force for our success: our patients benefit from very high pregnancy rates and one of the lowest multiple rates in the country.
But what leads some centers to transfer multiple embryos if SET is so successful? Often, patients are understandably frustrated by the time it can take to achieve a successful pregnancy. Many people either do not have insurance or have very limited insurance, so it seems natural for both patients and providers to want to “speed up the process” and transfer multiple embryos.
The problem is, with some patients, transferring more than one embryo doesn’t necessarily increase their pregnancy rate at all. For instance, if you were under 32 years old, your pregnancy rate would not significantly increase if you transferred two embryos instead of one; however, transferring two embryos would increase the twin rate to 30%. In addition, one embryo still has the potential to split on its own—and, while not common, it is very possible for the two embryos to become triplets.
There is also cost to consider. You may not see the immediate cost-benefit to SET, but the cost of a multiple birth is much higher. A preterm baby’s neonatal intensive-care unit (NICU) stay can cost hundreds of thousands of dollars.
Multiple births also increase risks for mother and baby, including, but not limited to miscarriage, preterm birth and subsequent developmental and/or health consequences, gestational diabetes, preeclampsia, placentation issues and stillbirth. Many of our patients have suffered years of infertility and/or multiple miscarriages. The last thing we want is to purposefully increase a patient’s risk of a bad outcome.
Ultimately, providers should make SET easier for patients. Our IVF programs include several embryo transfers for the same cost, to make it more feasible for our patients to have a single embryo transfer, but not worry about the extra cost.
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"I feel so lucky to have found RADfertility. I tried two other clinics before I expanded my search and found RADfertility. I drive an hour each way to go to them but I don’t regret a thing. They are so caring and so professional. Every time I message them they respond quickly. Every time I see them they have a friendly smile and warm welcome. They explain everything so well and I never feel lost in the process as I did elsewhere. They also took the time to figure out what was wrong. Other clinics threw up their hands, said 'I don’t know' and pushed me to try IVF."
"Dr. Feinberg and the entire staff at RADfertility are absolutely amazing. The receptionists, coordinators, nurses, and lab staff are compassionate, caring, and straight forward. I’ve had a 12-year infertility journey and I’ve tried other clinics but RADfertility was the only one I felt at ease with. They answered any questions that I had and were there any time I needed them. My coordinator, Amy, was the absolute best and always had my back. Dr. Feinberg’s dedication to his patients is incredible. You are not just a number there, you are a person with individualized needs and care."
"My journey with RADfertility and Dr. McGuirk started when my husband and I were trying to conceive and were having difficulty. We went to RADfertility, where we met Dr. McGuirk. I always say she changed my life and 'fixed' me. Dr. McGuirk is always learning more about endometriosis and how to help her patients. She’s brilliant and truly cares for you! I’m eternally grateful to her and everyone at RADfertility for their unwavering support, love, and care."
"Every step of our journey was tailored to us. We were treated so respectfully. Every detail was clearly explained and we felt so comfortable. Rhonda Wright was a Godsend and inspiring. I highly recommend this place! I cried when my weekly appointments were done and I 'graduated.'"
"The day I met Dr. Neithardt I knew she was the perfect doctor for me. Dr. Neithardt was so compassionate every step of the way. She held my hand, she hugged away tears, and continued to give me hope. There are not enough 'thank you's' in the world for Dr. Neithardt and the whole RADfertility team who will forever have a special place in my heart."
"RADfertility's staff has heart and provided me with exceptional health care. I knew I was in good hands and felt like we were in this together. The doctors and nursing staff always answered all of my questions and provided thorough information about all of my options. I am so fortunate and appreciative of the care that I received at RADfertility. They go above and beyond."
"I cannot begin to explain how wonderful RADfertility is. We were frustrated with trying to start a family and it not working for us. The entire team of doctors and nurses made us feel comfortable and hopeful that we would be parents. We experienced so many ups and downs but we never felt like we were on our IVF journey alone, we had our RADfertility team every step of the way. If you're looking for a supportive team on the IVF journey, look no further. RADfertility is the absolute best."
"Dr. Schillings always kept us informed and never gave up on us. She always explained our options and risks with each procedure. She called us personally when there were any issues or sensitive subjects to cover. Dr. Schillings was the first doctor that had answers for us and wanted to help us have our miracle baby!"
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