Embryo Transfer: Factors to Consider
Embryo transfer and elective single embryo transfer (eSET) have become popular topics as more couples turn to fertility treatments to conceive. The American Society for Reproductive Medicine (ASRM) has created embryo transfer guidelines based on national in vitro fertilization success rates. Under these guidelines your fertility doctor takes your age and in vitro fertilization (IVF) prognosis into account when performing embryo transfer. These ASRM guidelines offer you the best chances for a healthy pregnancy and delivery.
Success with IVF
Do you have a good prognosis for IVF? A good, or favorable, IVF prognosis applies to women who:
- Are in their first IVF cycle
- Have healthy embryos or multiple frozen embryos
- Have already had success with IVF
If you are under 35, and have a favorable prognosis for IVF, you are more likely to conceive with a single embryo transfer. If you're over 35 and have a good IVF prognosis, your doctor may prefer to transfer more than one embryo. ASRM guidelines recommend the following number of embryos for those with a favorable IVF prognosis:
- Under 35: 1-2 embryos
- 35 to 37: 2 embryos
- 38 to 40: 2 to 3 embryos
- 41 to 42: 3 to 5 embryos
If you do not have a favorable prognosis, your doctor may increase the number of embryos listed above by one.
Transferring one or more embyros
You may worry that a single embryo transfer with IVF isn't enough. IVF is such an expensive, time-consuming, and stressful process. Why take the chance with one embryo when your doctor can transfer multiple embryos? Dr. Lowell Ku, Reproductive Endocrinologist with Dallas IVF in Frisco, TX, explains: "Based on data published in 2010, a couple may benefit from elective single embryo transfer (eSET), despite the lowered chance of success, since the chance of having multiples drops significantly."
Concerns with multiple gestation
Becoming pregnant with multiples increases the risk of complications for you and your babies. Single embryo transfer can help you avoid these risks. The most common complications associated with multiples are increased rates of preterm labor and preterm delivery. Preterm delivery can cause a host of problems for the infant, including:
- Respiratory, growth, and digestive problems
- Long-term learning and developmental difficulties
- Low birth weight
- NICU (neonatal intensive care unit) stay
Complications for mom are also increased with multiple gestation. Here are some of the increased health risks for moms of multiples:
- Emotional stress
- Gestational diabetes
- High blood pressure and preeclampsia
- Increased cost for medical care
- Increased risk of miscarriage
This is why doctors prefer single embryo transfer, or transferring a lower number of embryos during IVF, when possible.
The Society for Assisted Reproductive Technology (SART) considers the ideal IVF outcome to be the birth of a single, healthy child. Responsible embryo transfer can help you achieve this goal. ASRM guidelines increase your chances of getting pregnant while reducing your chances of conceiving multiples.
“Women considering IVF should talk to their doctor about how many embryos to transfer that will be in the best interest of the woman and her baby’s health,” concludes Dr. Ku.