“SET is a very good and important strategy, and I think that we need to do more of it in the United States in order to reduce the rate of multiple pregnancies,” he said. “But this is not something that works for all patients, and that really needs to be strongly emphasized. It's not possible to make a single rule that applies to all patients; we certainly do not believe that in the United States. … We don't believe that regulation by the government which tells patients how they should make reproductive choices is the appropriate thing to do.”
That type of government regulation is largely responsible for Europe's high SET rate. The free IVF treatment provided by many European countries comes with legislative strings attached that mandate SET or severely restrict the number of embryos placed in certain women. European physicians have feared that this approach could limit pregnancy, and this is generally assumed to be one of the reasons for Europe's lower overall IVF pregnancy rate.
But certain European countries such as Sweden appear to have mastered the art of using SET effectively. “In Sweden we have shown no overall decline in pregnancy rates,” said Dr. Karl Nygren, chair of the EIM Consortium. “It has been possible to maintain the pregnancy rate even with a dramatic shift to 70% SET in Sweden, and we have reduced our twin pregnancy rate to 5%,” Dr. Nygren said. The consortium reported a Swedish pregnancy rate of roughly 34% per embryo transfer, which is significantly lower than the U.S. rate of 40.6%.