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Selecting the best embryo to transfer to the uterus is key to successful in vitro fertilization (IVF). A huge amount of research has been devoted to this topic and there are numerous methods used, from simple morphological assessment to molecular biological techniques to assess the genome and metabolism of the newly fertilized embryo. For many of these techniques, an adequate evidence base is lacking, and expert opinion is valuable. Clinical imperatives require ranking all embryos in a cohort according to their viability, thereby enabling the selection of the best embryo to optimize live birth outcome: a key indicator used to measure and rate IVF Clinics worldwide. This clear and informative manual will provide embryologists and clinicians with an overview of the tools now available to assist in embryo selection, as well as evidence for their efficacy and safety and the broader considerations that must underlie these important clinical decisions.
Multiple pregnancies are the most frequent and serious complication of assisted reproduction. Both high-order multiple and twin pregnancies entail a number of medical and economic outcomes that affect the children, the mother, the parents, the families, and society as a whole. Limiting the number of embryos to transfer is the only method available to decrease the incidence of multiple pregnancies. Single Embryo Transfer reviews the advantages and limitations of this approach to assisted reproduction. The crucial issue of selecting the best embryo will be reviewed in detail. All clinical issues involved in setting up and running an SET programme will be covered, including important topics such as cryopreservation of embryos, embryo donation, and patient counselling. The final chapters on future SET trends in Europe and North America are written by leading figures in the IVF world. The book is of interest to physicians, embryologists, nurses, insurers, politicians, ethicists and patients.