Patient response to a mandatory single blastocyst transfer policy

Abstract

OBJECTIVE: To determine whether infertile couples are supportive of a mandatory single blastocyst transfer policy (mSBT). DESIGN: Survey of all infertile patients undergoing embryo transfer at University of Iowa after implementation of a mSBT policy, which requires women 37 and younger to transfer only one good quality blastocyst if available. MATERIALS AND METHODS: Patients completed an Internet-based survey immediately following their embryo transfer procedure. Couples were approached only once during the study period. Variables used for comparison included age, education level, religion, previous pregnancies and deliveries, past IVF success, duration of infertility, warranty program participation, insurance coverage, personal and societal concerns regarding multiple gestations. Level of support was evaluated both as a dichotomous yes/no and as a continuous response on a 4-point scale ranging from unsupportive to extremely supportive. Subgroup analyses were then performed to assess support specifically among patients who qualified for single blastocyst transfer. χ2, t-test and 1-way ANOVA analyses were done where appropriate to test associations. RESULTS: 216 couples were approached and 210 participated in this survey (response rate = 97.2%). 92% of couples were supportive of mSBT. Preliminary results show that among couples favoring the mSBT policy there is a higher personal and societal concern about multiple gestations (p < 0.0001 and p <0.015, respectively). Support for mSBT was not significantly different in women who qualified for the policy vs. those who did not qualify for the program (p=0.135). CONCLUSIONS: The majority of patients were supportive of our mSBT policy regardless of whether they qualified for this policy. Personal and societal concerns for the increase in multiple gestations were the only variables significantly associated with support for this policy. A single blastocyst transfer policy is an acceptable and effective way to reduce the number of multiple gestations resulting from IVF/ICSI.