{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:05:47Z","timestamp":1784761547705,"version":"3.55.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Studies had compared single-embryo transfer to double-embryo transfer with cleavage stage embryos and found that while single-embryo transfer was less costly, it was also associated with a lower live birth rate than double-embryo transfer. A single blastocyst transfer has been shown to improve the live birth rate per cycle compared to single-embryo transfer at cleavage stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To compare live birth rates and real costs of elective single-embryo transfer to double-embryo transfer and to determine the incremental cost-effectiveness ratio of these two strategies in an unselected pool of women in a single center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed data of 4232 women who underwent their first fresh in vitro fertilization\/intra-cytoplasmic sperm injection cycles with at least two embryos available for transfer in KK Women\u2019s and Children\u2019s Hospital from 2010 to 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Five hundred and sixty-four women underwent elective single-embryo transfer and 3668 women underwent double-embryo transfer. One hundred and fifty-six women who failed to achieve a live birth in their fresh elective single-embryo transfer cycle underwent a sequential thaw single-embryo transfer cycle. Live birth rate of fresh elective single-embryo transfer was significantly higher at 41.3% than that of double-embryo transfer at 32.6%. Cumulative live birth rate for sequential elective single-embryo transfer (fresh elective single-embryo transfer\u2009+\u2009thaw single-embryo transfer) was 47.9%. After accounting for variables which may affect live birth rates such as age and stage of embryo transfer, the odds of achieving a live birth from double-embryo transfer was 24% lower than that from sequential single-embryo transfer, although not statistically significant. For every live birth gained from an elective single-embryo transfer compared to double-embryo transfer, cost savings were S$20,172 per woman. If a woman had to have a sequential single-embryo transfer after a failed single-embryo transfer in her fresh cycle, cost savings were reduced to S$1476 per woman.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Single-embryo transfer is a dominant strategy in an unselected population and adopting it in assisted reproductive treatments (ART) can produce cost savings without compromising on live birth rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057231206312","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T03:11:10Z","timestamp":1698635470000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcomes and cost analysis of single-embryo transfer versus double-embryo transfer"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3112-4511","authenticated-orcid":false,"given":"Ker Yi","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng Hao","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Carson","family":"Allen","sequence":"additional","affiliation":[{"name":"Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JKY","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tat Xin","family":"Ee","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka-Hee","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie Wai Leng","family":"Phoon","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronique","family":"Viardot-Foucault","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadhana","family":"Nadarajah","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tse Yeun","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"bibr1-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.19.1832"},{"key":"bibr2-17455057231206312","unstructured":"Richens H. Multiple births: moving towards a year 2 target. Human Fertilisation & Embryology Authority, 2009, https:\/\/www.hfea.gov.uk\/about-us\/our-campaign-to-reduce-multiple-births\/"},{"key":"bibr3-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.11.050"},{"key":"bibr4-17455057231206312","volume":"8","author":"Kamath MS","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr5-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dml053"},{"key":"bibr6-17455057231206312","doi-asserted-by":"crossref","first-page":"i1","DOI":"10.1093\/humrep\/31.Supplement_1.1","volume":"31","author":"Lopez-Regalado ML","year":"2016","journal-title":"Human Reprod"},{"key":"bibr7-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002118.pub4"},{"key":"bibr8-17455057231206312","doi-asserted-by":"publisher","DOI":"10.4103\/jhrs.JHRS_117_17"},{"key":"bibr9-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.10.032"},{"key":"bibr10-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.02.107"},{"key":"bibr11-17455057231206312","volume-title":"Economic evaluation in health care: merging theory with practice","author":"Drummond M","year":"2002"},{"issue":"4","key":"bibr12-17455057231206312","first-page":"195","volume":"9","author":"Abuzeid OM","year":"2017","journal-title":"Facts Views Vis Obgyn"},{"key":"bibr13-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000579"},{"key":"bibr14-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew216"},{"key":"bibr15-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dey294"},{"key":"bibr16-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2017.04.031"},{"key":"bibr17-17455057231206312","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmq028"},{"key":"bibr18-17455057231206312","unstructured":"Ministry of Health Singapore. Government co-founding scheme for assisted conception procedures at public hospitals, https:\/\/www.moh.gov.sg\/cost-financing\/healthcare-schemes-subsidies\/marriage-and-parenthood-schemes (accessed 25 May 2020)."},{"key":"bibr19-17455057231206312","unstructured":"Teo J. More Singapore couples getting help to conceive. The Straits Times, 22 March 2016, https:\/\/www.straitstimes.com\/singapore\/health\/more-singapore-couples-getting-help-to-conceive (22 March 2016)."}],"container-title":["Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057231206312","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17455057231206312","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057231206312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:26:32Z","timestamp":1777710392000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17455057231206312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":19,"alternative-id":["10.1177\/17455057231206312"],"URL":"https:\/\/doi.org\/10.1177\/17455057231206312","relation":{},"ISSN":["1745-5057","1745-5065"],"issn-type":[{"value":"1745-5057","type":"print"},{"value":"1745-5065","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"article-number":"17455057231206312"}}