***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND We analysed the difference in maternal , neonatal and total costs after single ( SET ) versus double day 3 embryo transfer ( DET ) . METHODS We performed a two-centre prospect i ve study of women in their first IVF/ICSI cycle choosing between  SET or DET . Infertility treatment data were gathered from a data base ; maternal and neonatal outcome data from a case report form ( CRF ) ; health economic data from medical acts registered in the CRF for the outpatient part and from hospital bills . SET was performed in 206/367 ( 56.1 % ) and DET in 161/367 ( 43.9 % ) women . RESULTS In all , 367 transfers yielded 186 positive pregnancy tests , 148 ongoing pregnancies and 136 live deliveries ( 50.7 , 40.3 and 37.1 % per embryo transfer ) of which 15 ( 11.0 % ) were twins . Live birth rate was 37.4 % for SET , 36.6 % for DET . Intention-to-treat analysis showed differences for : duration of pregnancy ( SET : 39.0 + /- 1.4 versus DET : 38.3 + /- 2.2 weeks ; P = 0.055 ) , percentage prematurity ( 8.5 versus 23.8 % ; P = 0.033 ) , percentage of neonates hospitalized ( 5.7 versus 17.9 % ; P = 0.121 ) and duration of neonatal hospitalization ( 6.3 + /- 2.2 versus 10.3 + /- 10.1 days ; P = 0.01 ) . Total cost after DET was higher ( SET : 4700 + /- 3239 versus DET : 8613 + /- 10 105 ; P = 0.105 ) , due to significantly higher neonatal costs ( 451 + /- 957 versus 3453 + /- 8154 ; P < 0.001 ) and not to differences in maternal costs ( 4250 + /- 2882 versus 5160 + /- 4106 ; P = 0.152 ) . CONCLUSIONS This prospect i ve health economic study shows that transfer of a single top quality embryo is equally effective as , but substantially cheaper than , double embryo transfer in women < 38 years of age in their first IVF/ICSI cycle BACKGROUND Transfer of several  embryos  after  IVF  results in a high multiple birth rate associated with increased morbidity and high costs for the neonatal care . In a previous r and omized trial we demonstrated that a single embryo transfer ( SET ) strategy , including one fresh single embryo transfer and , if no live birth , one additional frozen-thawed SET , result ed in a live-birth rate that was not substantially lower than after double embryo transfer ( DET ) but markedly reduced the multiple birth rate . METHODS We compared costs for maternal health care and productivity losses and paediatric costs for the SET and DET strategies . In addition , maternal and paediatric outcomes between the two groups were compared . RESULTS The SET strategy result ed in lower average total costs from treatment until 6 months after delivery . There were a few more deliveries with at least one live-born child in the DET group . The incremental cost per extra delivery in the DET alternative was high , 71 940 . The rates of prematurely born and low birthweight children were significantly lower with the SET strategy . There were also markedly fewer maternal and paediatric complications in the SET group . CONCLUSIONS The SET strategy is superior to the DET strategy , when number of deliveries with at least one live-born child , incremental cost-effectiveness ratio and maternal and paediatric complications are taken into consideration . The findings do not support continuing transfers of two embryos in this group of patients Background The ' Hawthorne Effect ' may be an important factor affecting the generalisability of clinical research to routine practice , but has been little studied . Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge , no attempt has been made to quantify them . Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia . Methods Participants in a dementia trial were r and omised to intensive follow-up ( with comprehensive assessment visits at baseline and two , four and six months post r and omisation ) or minimal follow-up ( with an abbreviated assessment at baseline and a full assessment at six months ) . Our primary outcomes were cognitive functioning ( ADAS-Cog ) and participant and carer-rated quality of life ( QOL-AD ) . Results We recruited 176 participants , mainly through general practice s. The main analysis was based on Intention to treat ( ITT ) , with available data . In the ANCOVA model with baseline score as a co-variate , follow-up group had a significant effect on outcome at six months on the ADAS-Cog score ( n = 140 ; mean difference = -2.018 ; 95%CI -3.914 , -0.121 ; p = 0.037 favouring the intensive follow-up group ) , and on participant-rated quality of life score ( n = 142 ; mean difference = -1.382 ; 95%CI -2.642 , -0.122 ; p = 0.032 favouring minimal follow-up group ) . There was no significant difference on carer quality of life . Conclusion We found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia result ed in a better outcome than minimal follow-up , as measured by their cognitive functioning . Trial registration Current controlled trials : IS RCT BACKGROUND Elective single embryo transfer ( eSET ) in a selected group of patients ( i.e. young patients with at least one good quality embryo ) reduces the number of multiple pregnancies in an IVF programme . However , the reduced overall multiple pregnancy rate ( PR ) is still unacceptably high . Therefore , a r and omized controlled trial ( RCT ) was conducted comparing eSET and double embryo transfer ( DET ) in an unselected group of patients ( i.e. irrespective of the woman 's age or embryo quality ) . METHODS Consenting unselected patients were r and omized between eSET ( RCT -eSET ) ( n = 154 ) or DET ( RCT -DET ) ( n = 154 ) . R and omization was performed just prior to the first embryo transfer , provided that at least two 2PN zygotes were available . Non- participants received our st and ard transfer policy [ SP-eSET in a selected group of patients ( n = 100 ) , otherwise SP-DET ( n = 122 ) ] . RESULTS The ongoing PR after RCT -eSET was significantly lower as compared with RCT -DET ( 21.4 versus 40.3 % ) and the twin PR was reduced from 21.0 % after RCT -DET to 0 % after RCT -eSET . The ongoing PRs after SP-eSET and SP-DET did not differ significantly ( 33.0 versus 30.3 % ) , with an overall twin PR of 12.9 % . CONCLUSION To avoid twin pregnancies result ing from an IVF treatment , eSET should be applied in all patients . The consequence would be a halving of the ongoing PR as compared with applying a DET policy in all patients . The transfer of one embryo in a selected group of good prognosis patients leads to a less drastic reduction in PR but maintains a twin PR of 12.9 % BACKGROUND The main reason for adverse treatment outcome in assisted reproduction is the high rate of multiple pregnancies . The only strategy to avoid dizygotic twins is to transfer one embryo at a time . METHODS A total of 144 women , who had had at least four good quality embryos available after IVF/intracytoplasmic sperm injection ( ICSI ) and who had no more than one previous failed treatment cycle , were r and omized to have either one or two embryos transferred . The treatment outcomes including those after frozen embryo transfer were compared between these groups . RESULTS The clinical pregnancy rate per transfer was 32.4 % in the one embryo transfer group and 47.1 % in the two embryo transfer group , the difference being not significant . Eleven twin deliveries ( n = 39 ) occurred in the two embryo transfer group and there was one pair of monozygotic twins in the one embryo transfer group . The cumulative pregnancy rate per patient after transfer of fresh and frozen embryos was 47.3 % in the one embryo transfer group and 58.6 % in the two embryo transfer group . CONCLUSIONS Our results indicate that among women who have good quality embryos in their first IVF/ICSI  , good treatment results can be achieved . They support the idea of changing embryo transfer policy towards one embryo transfer without any remarkable decrease in the success rate , while dizygotic twins can be avoided BACKGROUND With the aim of reducing the number of multiple pregnancies after IVF  we investigated the effectiveness of two cycles with single embryo transfer ( SET ) and one cycle with double embryo transfer ( DET ) after IVF and calculated the cost-effectiveness of both strategies . METHODS A r and omized controlled trial was performed in 107 women , aged < 35 years , in their first IVF cycle , with at least one good quality embryo . They were r and omized to the  SET ( n = 54 ) or DET ( n = 53 ) group using a computer-generated r and om block number table , stratified for primary or secondary infertility . RESULTS The cumulative live birth rates per woman r and omized of two consecutive cycles of SET [ 41 % ; 95 % confidence interval ( CI ) 27 - 54 ] versus one cycle of DET ( 36 % ; 95 % CI 23 - 49 ) were comparable , whereas the multiple pregnancy rate was significantly higher : 37 % ( 95 % CI 15 - 59 ) in the DET and 0 % in the in the SET group ( P = 0.002 ) . Combining the medical costs of the IVF treatments ( where 1.5 more SET cycles were required to achieve each live birth ) and of pregnancies up to 6 weeks after delivery , the total medical costs of DET per live birth were 13,680 and 13,438 for SET . CONCLUSIONS Two cycles with SET were equally effective as one cycle with DET , and the medical costs per live birth up to 6 weeks after delivery were the same . However , if lifetime costs for severe h and icaps are included , more than 7000 per live birth will be saved after implementing SET . Because of the high probability of multiple pregnancies in this group of IVF patients , only SET should be performed BACKGROUND The purpose of this study was to assess the effect of alternative ways of providing information about the risks of twins on couples ' perceptions about  elective single embryo transfer ( eSET ) . METHODS Couples undergoing IVF were r and omized into three groups . Group 1 received a st and ard information pack , group 2 an extra information leaflet about twin pregnancy , and group 3 an additional discussion session . The primary outcome measure was acceptability of a hypothetical policy of eSET .  Data were collected by means of a question naire . RESULTS eSET was acceptable to 17 ( 27 % ) , 20 ( 30 % ) and 24 ( 32 % ) couples in groups 1 , 2 and 3 , if it meant a slight reduction in pregnancy rates , and to 51 ( 82 % ) , 55 ( 83 % ) and 53 ( 87 % ) couples , respectively , if pregnancy rates were unchanged . A fixed charge for all fresh and frozen embryo transfers following a single oocyte retrieval led to acceptability rates of 35 ( 57 % ) , 36 ( 55 % ) and 38 ( 65 % ) . CONCLUSIONS Additional information , involving an extra information leaflet and face to face discussion , did not changes couples ' attitudes towards eSET . Maintaining existing rates of pregnancy and offering a fixed charge for all embryo transfers result ing from an oocyte recovery may encourage more couples to consider eSET OBJECTIVE To determine the extent to which embryo selection by blastulation and elective single blastocyst transfer , supported by efficient cryostorage of spare embryos , can reduce multiple pregnancies and maintain or improve on the live birth rate from IVF . DESIGN Prospect i ve , nonr and omized cohort study . SETTING Sydney IVF , a private clinic in Australia . PATIENT(S ) In vitro fertilization patients aged < 38 years with three or more usable blastocyst , recruited from April 2000 through December 2001 , with pregnancies followed up until August 2004 . INTERVENTION(S ) Blastocysts were cultured and cryostored with stage-specific culture medium and low oxygen conditions . MAIN OUTCOME MEASURE(S ) Fetal heart-positive twin pregnancy rate and accumulating " take-home baby " rate per retrieval leading to blastocyst transfer . RESULT ( S ) Among 121 women who elected single fresh blastocyst transfer ( but who could elect to have two frozen blastocysts transferred at once ) , 79 ( 65.3 % ) took home a baby , with a twin pregnancy rate of 7 % . Among 285 women who chose two blastocysts for fresh transfer , 184 ( 64.2 % ) took home at least one baby , with a twin pregnancy rate of 34 % and five perinatal deaths . CONCLUSION ( S ) With 
    Output:
    
( S ) Elective single embryo transfer is associated with decreased risks of PTB and LBW compared with DET but higher risks of PTB compared with spontaneously conceived singletons