Objective: To investigate the cumulative delivery rate for women completing three fresh embryo transfer cycles or giving birth after the first or second transfer cycle in an in vitro fertilization program with a single embryo transfer (SET) policy.
Setting: Privately run infertility clinic in southern Sweden (Skåne region).
Population: Four hundred fifty-three consecutive, unselected public patients beginning an ovum pick-up cycle between July 2002 and June 2004.
Method: Retrospective, observational study.
Main outcome measure: Cumulative delivery rates.
Results: Of 370 women who completed the study with up to three fresh ET cycles (90% SETs), 244 women (66%) progressed to delivery. Among the deliveries were three sets of twins (1%), one dizygotic. Cumulative delivery rates showed significant differences relative to age <36 (71%) and >or=36 years (47%), and delivery rates relative to rank of ET cycle (first and second vs. third ET cycle - 35, 34, and 21% delivery rates, respectively).
Conclusions: The 66% cumulative delivery rate is in accordance with rates in similar observational studies and in estimation studies, in which predominantly two embryos were used for transfer. The multiple delivery rate was low. We suggest that repeated SET cycles can be implemented on a large scale even in a primarily unselected patient population without compromising the outcome.