Mandatory single embryo transfer policy dramatically decreases multiple pregnancy rates

Aim The aim of this study is to determine the effect of a mandatory single embryo transfer (SET) policy on pregnancy rates and multiple pregnancy rates in intracytoplasmic sperm injection (ICSI) cycles. Methods One hundred and twenty‐eight patients (154 cycles) underwent ICSI before the Turkish Ministry of Health's legislation, 55 patients (69 cycles) underwent ICSI after the legislation (day‐3 embryo transfers only) and 35 patients (39 cycles) who underwent ICSI after the legislation (day‐5 embryo transfers only). Results Groups were comparable regarding the women's mean age and body mass index. The number of embryos transferred (2.7 ± 0.5 vs 1.0 ± 0.0 vs 1.0 ± 0.0) was significantly higher in group I, compared to group II and group III. Clinical pregnancy per embryo transfer (40.8% vs 15.1% vs 36.1%) and live birth rate (37.7% vs 13.2% vs 30.6%) were significantly lower in group II when compared to group I and group III. Multiple pregnancy rates (39.6% vs 0.0%, vs 0.0%) were significantly higher in group I when compared to group II and III. Implantation rates were significantly higher in group III when compared to group I and group II. Miscarriage rates were comparable among the groups. Conclusion The mandatory SET policy caused a dramatic decrease of multiple pregnancy rates. Mandatory SET with only day‐3 embryo transfers decreased the pregnancy rates but this detrimental effect was not seen in cycles with day‐5 embryo transfers.