What is Elective Single Embryo Transfer (eSET)?

eSET is a process in IVF where a single embryo is chosen from a group of high-quality embryos to be implanted into the uterus. The selected embryo can be fresh or previously frozen from an earlier IVF cycle. This approach aims to increase the chances of a healthy, singleton pregnancy rather than multiple pregnancies (twins, triplets, or more).

Why Consider eSET?

Following are the health benefits associated with eSET for mother and baby:

1. Reduced Risks for the mother: Carrying multiple babies can lead to complications like preterm labor, gestational diabetes, high blood pressure (preeclampsia), and the need for a Cesarean section (C-section). These complications can result in longer recovery times and increased risks during childbirth.

2. Healthier Babies: Multiple pregnancies often result in babies being born prematurely, which can lead to low birth weight and health problems such as breathing difficulties, developmental delays, and cerebral palsy. Singleton pregnancies are generally safer and result in healthier babies.

3. Higher Success Rates with Improved Techniques: Advances in IVF techniques and embryo cryopreservation (freezing) have increased the success rates of single embryo transfers. It means that even if only one embryo is transferred, the chances of a successful pregnancy and healthy birth are higher than in the past.

Who is a Good Candidate for eSET?

Not everyone undergoing IVF is a suitable candidate for elective single embryo transfer (eSET). However, certain factors make someone an ideal candidate for this procedure:

1. Age: Women under the age of 35 are typically better candidates for eSET. Younger women generally have higher-quality eggs and embryos, which increases the chances of a successful pregnancy with a single embryo transfer. Women ages 35-40 years should also consider eSET if they have top quality day 5 embryos available.

2. Embryo Quality: The availability of multiple high-quality embryos significantly boosts the likelihood of success with eSET. High-quality embryos have a better chance of implanting successfully and developing into a healthy pregnancy.

3. Previous IVF Success: Women who have previously had successful IVF pregnancies are often good candidates for eSET. Their proven positive response to IVF treatment suggests a higher probability of success with a single embryo transfer.

4. Recipients of embryos from donated eggs

5. Patients with uterien abnormalities like Unicornuate uterus also are ideal for eSET.

These factors help doctors determine the best candidates for eSET, aiming to achieve a healthy singleton pregnancy while minimizing the risks associated with multiple births.

The Role of Medical Guidance and Personal Choice

The decision to opt for eSET involves both medical advice and personal choice. Doctors recommend eSET for patients with a good prognosis to reduce the risk of multiple pregnancies. However, some patients may still prefer transferring multiple embryos to increase their chances of getting pregnant, despite the associated risks.

Understanding the Risks of Multiple Pregnancies

While the desire to increase the chances of pregnancy is understandable, it’s important to recognize the significant risks associated with multiple pregnancies.

Making Decision: Is eSET Right for You? 

Choosing whether to use eSET requires careful consideration of several issues which you should discuss with your physician. To assist you in reaching a well-informed conclusion, follow these steps:

1. Assess Your Situation: Consider your age, health, and fertility history. If you are under 35 and have high-quality embryos, eSET might be a good option.

2. Discuss with Your Doctor: Talk to your doctor about the risks and benefits of eSET based on your circumstances. They can guide the likelihood of success and potential risks involved.

3. Consider the Long-Term Implications: Think about the practical aspects of raising multiples, such as the financial, emotional, and logistical challenges. Caring for multiple babies can be demanding and stressful.

4. Evaluate Support Systems: Consider the support from family, friends, and healthcare providers. A strong support network can help you manage the demands of pregnancy and parenting.

The Bottom Line

Elective single embryo transfer (eSET) is a valuable option for couples undergoing IVF, aiming to reduce the risks associated with multiple pregnancies and increase the chances of a healthy, single birth.

While not suitable for everyone, eSET offers significant health benefits for both the mother and the baby. By carefully considering your situation and discussing your options with a fertility specialist, you can make an informed decision that aligns with your values and goals for parenthood.


Who is eligible for elective single embryo transfer?

Women under 35 with high-quality embryos, those with previous IVF success, and first-time IVF patients or those using donor eggs are typically eligible for elective single embryo transfer (eSET).

What is eSET IVF?

eSET IVF is a procedure where only one high-quality embryo is transferred into the uterus during in vitro fertilization, aiming to reduce the risk of multiple pregnancies.

Is single embryo transfer better?

Single embryo transfer is often better as it reduces the risks associated with multiple pregnancies, leading to healthier outcomes for both the mother and baby.

Which grade embryo is best?

Top-grade and high-quality embryos are considered the best for transfer due to their higher chances of successful implantation and pregnancy.

Which stage of embryo is best for transfer?

Blastocysts, which are embryos at the day 5 stage, are often considered the best for transfer due to their higher likelihood of successfully implanting.