OBJECTIVE:

Previous experiences with fertility treatment and pregnancy outcomes may influence the likelihood of a patient choosing elective single embryo transfer (eSET). Our objective was to investigate whether desire to undergo eSET is associated with previous IVF experiences.

DESIGN:

Retrospective descriptive analysis of online cross-sectional survey.

MATERIALS AND METHODS:

An anonymous survey regarding eSET preferences and experiences was distributed through social media over a five-week span in 2014. This study focused on survey participants who completed at least one IVF cycle with embryo(s) transferred or were planning to undergo IVF. Respondents self-selected into one of five mutually exclusive groups based on IVF treatment history and outcomes (see Results for description of these groups). Outcome variables included preference for single embryo transfer (defined as transferring one embryo when multiple were available) vs. multiple embryo transfer (MET), and potential likelihood of undergoing multifetal reduction if advised by a provider. Participants with a multiple birth were excluded, as eSET preference data were missing. Bivariate analyses were performed using chi-squared for comparison of proportions among groups. Significant associations (p<.05) were included in a subsequent logistic regression analysis.

RESULTS:

759 of 888 participants met inclusion criteria. Six percent were planning for an IVF cycle (Group 1), 16% were pregnant for the first time as a result of IVF (Group 2), 37% had completed at least 1 IVF cycle with no resulting births (Group 3), and 41% had at least one singleton birth and no multiple births from IVF (Group 4). Compared to Group 3 (no IVF births), participants in Group 4 (at least one singleton IVF birth) were more likely to prefer eSET (OR 1.67[1.06-2.64]). Participants in Group 1 (planning for IVF) would be more likely to consider multifetal reduction if recommended by a physician (OR 2.15 [1.09-4.25]) than those in Group 3 (no IVF births). No other inter-group differences were seen.

CONCLUSION:

Patients with at least one live birth resulting from IVF may be more likely to elect eSET, possibly reflecting the increased psychological pressure of an unsuccessful IVF cycle. Patients early in infertility treatment may be most likely to consider multifetal reduction.