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    Single Embryo OK for Older Women

    <P>Embryo Quality Key to IVF Success</P>

    It's Different in the U.S. continued...

    But he adds that very significant differences in the U.S. and Finnish population of women undergoing IVF and embryo transfer make comparisons between the two groups difficult.

    Adamson is vice president of the American Society for Reproductive Medicine. He is in private practice in Palo Alto, Calif.

    IVF can cost anywhere from $10,000 to $15,000 in the U.S., and the patient typically pays the tab. In Finland and other Scandinavian countries, assisted reproduction is free to the patient.

    American women usually try cheaper infertility treatments before they move on to IVF, while women in Finland are more likely to be offered IVF from the start. Because of this, American women tend to be older when they first have IVF and they may have more severe infertility.

    Adamson points out that roughly five times as many women in Finland have IVF as in America.

    "It is easy to see that if five times as many women are doing this, many of them have less severe infertility," Adamson says. "They have not failed other therapies like many women in the U.S."

    He adds that the women in the study were highly selected, with only 27% considered to be good candidates for single embryo transfer. Almost three-quarters of the women in the study were not considered good candidates because the embryos available for transfer were of poorer quality.

    Adamson says it is clear that there are still too many multiple births occurring with assisted reproduction in the United States, but he says progress has been made.

    The transfer of three and even more embryos was common just a few years ago, but it is rare today unless the embryos are of very poor quality. As a result assisted reproduction-related triplet births were reduced by half between the late 1990s and 2003.

    Reproductive endocrinologists in the U.S. are increasingly recommending single embryo transfer to their patients with good-quality embryos, Adamson says. But more often than not, patients reject the idea because they are more concerned about IVF failure than having twins.

    "Multiple births are an important problem, but we must not forget that the purpose of assisted reproduction is to get a baby," Adamson says. "The only way to ensure no multiples is to have no live births at all."

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