Elective single embryo transfer

Elective single embryo transfer has been implemented in Belgium and Scandinavian countries to decrease the incidence of twin pregnancy and the associated complications. The extra cost associated with achieving an equal number of pregnancies through elective single embryo transfer needs to be considered in the context of any additional neonatal care expenses associated with double embryo transfer. Acceptable ongoing pregnancy and delivery rates have been obtained when comparing single with double embryo transfer. Maternal age, previous attempts, day of embryo transfer and cost should be taken into account. Learning objectives: To understand the issues raised when helping a couple choose single or double embryo transfer. Ethical issues: Where does patient autonomy over treatment end and national regulation begin? The management of obstetric complications and the long‐term sequelae of premature birth should be factored in when considering treatment costs. Please cite this article as: Kosmas I, Van der Elst J, Devroey P, Tournaye H. Elective single embryo transfer. The Obstetrician 10:163–169.