Fertility Blog

Japan Reports Improved Outcomes with eSET

The retrospective study looked at more than 140,000 live births and more than 500 stillbirths conceived using reproductive technology in Japan between 2007 and 2012. During this time period, a new eSET policy increased the rate of eSET from nearly 53 percent to nearly 83 percent, while multiple pregnancies decreased from nearly 11 percent to just over 4 percent.

During this 5-year period:

  • The rates of preterm birth (including before 32 weeks), low birth weight and very low birth weight, and small for gestational age decreased significantly.
  • Rates of large for gestational age increased.
  • Death around the time of birth (perinatal mortality) was nearly cut in half in fresh cycles.

Compared with eSET, double embryo transfers (DETs) were linked with:

  • A significant increase in multiple pregnancies
  • Placenta accreta—a serious complication where blood vessels and parts of the placenta grow too deeply into the uterine wall
  • Preterm premature rupture of membrane—when the sac containing the fetus and amniotic fluid bursts or develops a hole before the start of labor
  • Cesarean section
  • Preterm birth
  • Low birth weight
  • Small for gestational age
  • Early newborn (neonatal) death

In this study, a decrease in multiples appears to be the common thread linking a variety of improved outcomes with eSET—all good news for prospective parents needing IVF.


1.Takeshima K et al. Impact of single embryo transfer policy on perinatal outcomes in fresh and frozen cycles—analysis of the Japanese Assisted Reproduction Technology registry between 2007 and 2012. Fertility and Sterility. February 2016;105(2):337–346.e3.

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