Risks of untreated depression outweigh any risks of SSRIs.

only these figures show the real efficiency of the program (Veleva et al., 2009). One of the main findings in the present study was that even among older women there is a wide variation in the prognosis of the treatment (Niinimäki et al., 2012). As well as in any other age group, it is possible to select good prognosis women for eSET and at the same time maintain a good pregnancy rate as well as low multiple pregnancy rate. In our opinion, it is very important to maintain a low risk of multiple pregnancies among women over 40 years of age as women in advanced age have clearly increased risk of pre-eclampsia, impaired glucose tolerance and obesity than younger women (Lamminpää et al., 2012). We find that it would be irrational , or even unethical, to accept higher multiple birth rate among older women, if it is avoidable. We want to emphasize that our study was not randomized, and the two groups [eSET and double-embryo transfer (DET)] were highly selected by design. Therefore, the two study groups were not equal regarding the prognostic factors. Hence, the low number of twins in the DET group only indicated that the criteria for eSET or DET were feasible in the clinical practice, and not that DET would be a good option in all women in that age group. At our clinic all couples were carefully counselled by an experienced doctor on the benefits and risks concerning SET and DET in their particular situation. The opinion of the patients was taken into account and DET was performed if this was the wish of the couple and there were no medical contraindication for a twin pregnancy. We disagree with Gleicher (2012), that our patients' preferences would have been ignored for the sake of eSET policy. As stated in our paper, eSET should not be recommended to all IVF patients. The proportion of women suitable for eSET is lower among older age groups, as was also shown in this study. However, if the aim is to decrease risks and thus the number of multiple births, the advantages of eSET have been shown in many countries. By allowing two or even more high-quality embryos to be transferred among older women would expose many women to excessive risk of multiple birth and possible pregnancy complications. During the last 10 years eSET policy has been adopted in many countries. …