HOW MANY EMBRYOS SHOULD BE TRANSFERRED IN AN IVF CYCLE
How many embryos should be created or transferred?
The number of embryos transferred typically depends on the number of embryos available, previous obstetric history, maternal age and general heal. As the number of embryos transferred increases, pregnancy rates also improve upto three embryos and after that stabilises. However, a greater number of embryos transferred also increases the chances of having a multiple pregnancy. So, make sure that you discuss about the number of embryos to be transferred with your doctor before the procedure. Also make sure the clinic has a good cryopreservation unit. In any case, it should not be more than three. It is better to freeze any extra embryos and take another chances of transfer than to waste all embryos in one chance.
Blastocyst Transfer
It involves culturing of embryos in the lab for 5 days after retrieval and then transferring inside the uterus. Although it is considered that blastocysts are better in terms of implantation potential but the only drawback is that almost 50-60 % embryos proceed to blastocyst and thus there is a wastage of number of embryos. Ultimately there is not much gain in cumulative pregnancy rates. Also, it may incur extra cost.
Single Embryo Transfer
At Vasundhara hospital and fertility research centre Jaipur, our goal is to provide those seeking to start or add to a family with a single healthy baby. One of the undesirable side effects of IVF is that of multiple pregnancies. Our own success data shows that the chances of conception for those who develop good quality blastocysts is really high. It is for this patient population that we highly recommend and follow a single embryo transfer (SET) policy. In doing so, the overall success rate is only minimally decreased, while the risk of multiple pregnancy is reduced from 40-60% down to 2-3%. There are also certain circumstances such as congenital uterine anomalies like small uterus or partially developed uterus, previous fibroids surgery, caesarean section or previous pregnancy complications like hypertension or diabetes that may mandate a singleton pregnancy in order to lower the adverse effects of multiple pregnancy on the mother.
Individual IVF-ET programs and centres should evaluate their own data to develop patient-specific, embryo-specific, and cycle-specific determinants of implantation and live birth. This information can then be extrapolated to find out the overall chances of success in a particular case. This is how we should decide the number of embryos to be transferred in any particular case.This balance is important in order to minimize the occurrence of multifetal gestation while maintaining acceptable overall pregnancy and live birth rates.
Guidelines:
For patients < 35 years of age and a favourable prognosis, IVF clinicians should only transfer a single embryo, and not more than two embryos (the practice committee of ASRM 2013). For patients aged 38-40, and 41-42, ASRM states that no more than three and five cleavage-stage embryos, respectively, should be transferred. Patients, who have failed two or more IVF cycles or have a less favourable prognosis, can receive an additional embryo. For patients aged over 43, there is no limit.
Vasundhara hospital and fertility research centre is one of the most advanced fertility and IVF Hospital in Jaipur and believes in involving the couples in decision making at every step including the number of embryos to be transferred and the individualised success rates.
If you want to know more click here Infertility Centre in Jaipur.
