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    in vitro fertilisation (ivf)

    Number of Embryo Transfer in the First IVF

    • 4.5   (1 Votes)

    Embryo transfer refers to a process of transferring embryos into a womans uterus so that it may implant and continue to develop till birth. Women below the age of 35 require 1 to 2 embryos a woman above 40 years of age can have as many as 5 embryos or 3 blastocysts per transfer.

    Fertility treatments can be complicated and often require patients to make many decisions along the way. The toughest questions for patients undergoing IVF & Donor Egg treatment are “how many embryos should I transfer in the first IVF?” This is an important question and so it is important to understand the reasons why patients might struggle for the right answer. (1)

    For starters, some patients might actually want twins. The idea of building a family with only one round of IVF treatment sounds fascinating. Another reason is that patients want to improve their chances of success. Nobody wants a cycle to fail and transferring more than one embryo sometimes seems like the logical way to increase the chance of success. (2) Fertility treatment is often expensive and the idea of having to find the funds to repeat a treatment cycle can seem overwhelming.

    In this article we will look at:

    1. What is Embryo transfer?
    2. What is Elective Single Embryo Transfer (ESET)?
    3. What are the success rates in single vs. double embryo transfers?
    4. What is the success rates in double and multiple embryo transfers?
    5. How many embryos should be transferred?

    1. What is Embryo transfer?

    Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. (3) This technique is often used in connection with In Vitro Fertilization (IVF). Embryo transfer can be done at day two or day three, or later in the blastocyst stage. Embryo transfer is a 15-minute procedure accomplished by inserting a catheter with embryos into the uterine cavity. Some patients may only have one or two embryos that develop normally after retrieval. For these patients, there may not be an advantage of continuing on to the blastocyst stage. In these cases, clinics can transfer the embryo(s) to the uterus on day 2 or 3. For these embryos, the human body may be the optimal place for the embryo to grow and develop after fertilization. Usually, clinics transfer fewer embryos at the blastocyst stage than at the day 3 stage of development. This technique usually results in the highest pregnancy rates and reduces the risk of multiple pregnancies. This is a result of better implantation rates per blastocyst embryo transferred. Embryos destined to become babies likely have the same chances of implantation whether embryos are transferred at day 3 or day 5.

    2. What is Elective Single Embryo Transfer (ESET)?

    ESET or Elective Single Embryo Transfer is a process by which one good quality blastocyst (day 5) embryo is transferred back to the patient. The embryos that survive to theblastocyst stage of development are more likely to be healthy and strong. (4) Blastocyst embryos have a much higher chance of implanting than 4 cells (day 2) or 8 cells (day 3) embryos, therefore fewer embryos are required to achieve a successful pregnancy. When patients choose ESET, they give themselves the best possible chance for a safe pregnancy and a healthy baby. Since its inception in 2002, the number of patients choosing ESET has increased each year. In 2010, nearly 30% of all IVF patients and 41% of donor egg patients were elected to transfer a single embryo which resulted in a 61% clinical pregnancy rate for IVF and 62% pregnancy rate for donor egg. However, one size does not fit all for the number of embryos transferred. In such cases, a day 3 transfer may occur. A number of these patients may have two or rarely more embryos recommended for transfer. Patients undergoing a day 3 embryo transfer still have a good chance of pregnancy success rates but may end up transferring more than one embryo. If a patient is able to proceed with a day 5 transfer, it may be recommended to transfer only one embryo to reduce the high likelihood of multiple pregnancies.

    3. What are the success rates in single vs. double embryo transfers?

    A survey conducted on 513 women in 2011 indicated that the live birth rate does not vary much between single and double embryo transfers, with the cumulative live birth rate being 37.1%. Other one showed similar live birth rates between Double and Single Embryo Transfer, at about 42% and 45% respectively. Findings across various studies appear consistent in that there is not a significant difference in live birth rates with Double and Single Embryo Transfer to warrant a recommendation of Double Embryo Transfers in most cases. (5)

    Embyo transfer IVF

     4. What is the success rates in double and multiple embryo transfers?

    Some couples may opt for a DET (Double embryo transfers) /MET (Multiple embryo transfers) for various reasons. The primary reason is the perception that it may have a dramatic impact on their chances for success. IVF treatment is not only costly but can be extremely emotionally and physically stressful. So, couples are eager to do anything possible to avoid undergoing future cycles. MET is associated with a higher possibility of risk, partly because it often leads to multiple births. Preterm births are five times more likely with a double embryo transfer than a single embryo transfer. Multiples embryo transfers are more likely to have low birth weights, respiratory problems and other health problems at birth than single babies. In addition, patients are more likely to have high blood pressure and other pregnancy complications. (6)

    5. How many embryos should be transferred?

    Fertility clinic

    Usually, the number of embryones that can be transferred increases with an increase in the woman’s age, to compensate for the age-related decline in fertility. Both embryos between days 2 to 3 post-fertilization and blastocysts between days 5 to 6 post-fertilization may be considered for transfer into a woman’s uterus. (7) Blastocyst transfers are known to be more efficient than embryo transfers, and therefore, a fewer number of blastocysts are sufficient for Assisted Reproductive Technology purposes. According to the accepted guidelines, women below the age of 35 require 1 to 2 embryos or 1 blastocyst per transfer. On the other hand, a woman above 40 years of age can have as many as 5 embryos or 3 blastocysts per transfer. Apart from a woman’s age, the quality of the embryo or blastocyst and the Fertility Clinic determine the overall success of embryo transfer. (8)

    Follow OVO Fertility Blog for more information on Fertility treatments. Deciding how many embryos should be transferred for IVF is a difficult decision. Your fertility journey is unique and based on your own needs and situations. OVO Fertility can assist you in making the best decisions regarding IVF treatment, fertility problems, pregnancy-related problems, and other fertility issues. (9) Call us today at +918268260808 and book an appointment.



    1 Comment


    Tusya Sankait

    Feb. 22, 2019, 12:59 p.m. 4.5

    Leave a Comment



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    It is not advised to self-diagnose or treat any medical condition or disease following the information given in this article. We insist you to consult a registered practitioner and never try to replace their advice or discontinue treatment in between by relying solely on the information obtained. External links to different websites as well as videos given on the website serve the purpose of sharing knowledge only. Ovo Health being an Independent Medical Information platform is neither responsible nor guarantees the authenticity, reliability, and accuracy of these videos and websites in any way. We do not intend the information displayed here to be used for a medical emergency, if you seek medical attention for yourself (or any other person with whom you want to share the information with), we advise you to directly get in touch with the hospital or the doctor.

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