Many Canadian couples battling infertility turn to in vitro fertilization (IVF) to have a child. In Canada, IVF is not publicly funded, making the decision on the number of embryos to be transferred more complicated than in many European countries which link funding to elective single embryo transfer (eSET).
The joint clinical practice guideline, developed by the Society of Obstetricians and Gynaecologists of Canada (SOGC) and the Canadian Fertility and Andrology Society (CFAS), provides valuable insight to help guide that decision-making process.
The authors highlight the need for awareness and understanding of the various in vitro fertilization options available to Canadians, the burden of multiple birth pregnancies, the impact of a mother's age on the probability of success of IVF treatments, and the importance of public funding to reduce the main barrier to the adoption of elective single embryo transfer for both physicians and patients.
This guideline advances recommendations with a goal to reduce the incidence of multiple births in at-risk populations, while maintaining acceptable live birth rates. The conclusion: elective single embryo transfer for women under 35 with a good prognosis is the most efficacious and cost-effective option for Canadians.
Despite the lack of funding, it remains crucial to significantly reduce the number of IVF multiple pregnancies. In order to have the greatest impact in promoting the uptake of elective single embryo transfer, public funding of IVF must be provided.
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