How many embryos to transfer in an IVF cycle is an important decision. It has significant implications on the patient’s likelihood of pregnancy, risks of multiple births and other pregnancy complications. CHR has been a vocal advocate for patients’ right to self determination on this issue. We believe that it should be the patient who makes the decision, with full information and disclosure received from their physicians and embryologists.
Unfortunately, however, there has been a push toward uniformly recommending single embryo transfer (SET) in the reproductive endocrinology community. As we have pointed out in many occasions, a balanced approach is needed in order to minimize the risks associated with high-order multiples while maximizing the pregnancy chances for individual patients.
Advocates of this (in our opinion rational) approach is becoming rare, however, as the push toward elective SET has become more popular among colleagues, especially in Europe and Canada. It is then no surprise that The Wall Street Journal quoted Dr. Gleicher in a recent article exploring this issue. Sparked by a recent study published in Fertility and Sterility by a March of Dimes and the Hastings Institute task force in which Dr. Gleicher participated, the article examines the growing multiple birth rate in the U.S., discussing both the health risks of multiple embryo transfers (higher risk of premature births) and the lower chance of pregnancy with SET.
“I don’t think that single embryo transfer is a great option for women with infertility and particularly for older women with infertility or younger women who have low ovarian reserve,” Dr. Gleicher told the Journal, because women with low ovarian reserve may not have enough time left to have two babies consecutively, but could build a family with two children if they ended up having twins from a transfer of more than one embryos.
To learn more about CHR’s approach on patient empowerment surrounding the issue of SET, please visit the IVF and Twins page.