A major concern regarding IVF are the multiple gestations (triplets,
quadruplets, and quintuplets) resulting from the need to transfer back many
embryos in order to achieve an acceptable pregnancy rate. In countries where
there are mandatory limits as to the number of embryos transferred, multiple
pregnancy rates are less but, unfortunately, the overall pregnancy rate is
also less. Our goal is to maximize your likelihood of becoming pregnant and
minimize the chance of having a multiple birth.
Depending on the number of eggs obtained, embryos generated and the developmental
progression of the embryos, we will decide on the optimal day for the embryo
transfer.
It is our practice to comply with the embryo transfer guidelines set forth
by the American Society for Reproductive Medicine:
- For patients < age 35 and in the absence of extra-ordinary circumstances,
no more than 2 embryos should be transferred.
- For patients with the most favorable prognosis, consideration should
be given to transferring only a single embryo. Patients having the most
favorable prognosis
include those who are undergoing their first cycle of IVF, have good
quality embryos as judged by morphologic criteria, and have excess of
embryos of sufficient
quality to allow embryo freezing. Patients who have had previous success
with IVF should also be considered in the most favorable prognostic category.
- For patients between 35 and 37 years of age having a more favorable prognosis,
no more than 2 embryos should be transferred. All others in this age
group should have no more than 3 embryos transferred.
- For patients between 38 and 40 years of age, no more than 4
embryos should be transferred. For patients in this age group having a more
favorable
prognosis, consideration should be given to transfer of no more than
3 embryos.
- For most patients greater than 40 years of age, no more than 5 embryos
should be transferred.
- For patients with two or more previous failed IVF cycles and those
having a less favorable prognosis, additional embryos may be transferred
according
to
individual circumstances after appropriate consultation.
- In donor egg cycles, the age of the donor should be used to determine
the appropriate number of embryos to transfer.
