How many embryos should be transferred?

Fertility treatments such as IVF can be complex, sometimes involving many decisions along the way. One of the hardest questions couples face is “how many embryos should I transfer?” to maximize pregnancy rates and minimize risks.

In vitro fertilization is the process of stimulating the ovaries to produce many eggs, which are removed and fertilized with sperm to form embryos. The embryos are then grown for several days in an artificial medium before being transferred to the mother's uterus.
The maximum number of embryos should be transferred to be effective for assisted reproductive technology and to ensure safety for the next pregnancy, which is always a big challenge for infertility doctors. The transfer of many embryos at the same time increases the pregnancy rate but will also increase the chance of twins, triplets, etc., becoming a burden for pregnant women, especially older women who still want to give birth. want to have children.
In the early days when the new IVF technique was applied, many of the laboratories and clinical settings used were still relatively new and incomplete. Therefore, the chance of pregnancy for each embryo transfer is low. From there, clinics tend to transfer multiple embryos, from 2, 3 or even 4 at once, in the hope of a higher chance of pregnancy. However, with this method of pregnancy, the result is often a multiple pregnancy, which carries a high risk of pregnancy complications, including preterm delivery.
Currently technology related to in vitro fertilization technique has improved a lot over the years. These advances have resulted in a much higher chance of pregnancy per transferred embryo. The way embryos are cryopreserved also gives many achievements. This means that a woman can have a higher pregnancy rate while transferring relatively few embryos. Therefore, the rate of multiple pregnancies with triplets and quadruplets has decreased significantly in recent years, helping to ensure the safety of mothers and babies during the perinatal period.

In 2009, to establish standards for the number of embryos that should be transferred when performing in vitro fertilization, the American Society for Reproductive Medicine (ASRM) published guidelines, guidelines for the maximum number of embryos Multi suitable for transfer.
These guidelines suggest the maximum number of embryos to be transferred based on the date of transfer (multicellular day 3 vs day 5 blastocyst), prognostic classification (favorable embryo to be transferred compared with all other embryos) remaining) and especially important is the age of the woman. Accordingly, for most cases, these guidelines discourage multiple embryo transfers, particularly in patients younger than 40 years of age.
Here are the details of the maximum number of embryos to be transferred according to the ASRM guidelines on the number of embryos to be transferred:

Many couples wish to have twins as the ultimate goal to achieve from IVF. While such pregnancies can be a good thing as long as there are no problems, carrying multiples (even twins) can increase obstetric complications. Therefore, the goal of most infertility specialists is to simply obtain single pregnancies.
For this purpose, some experts have advocated single-embryo transfer, i.e. transferring only one embryo, at a time, to one patient. From there, the pregnancy process will become more physiological and achieve safer goals for both mother and baby.
However, in some cases, even single-embryo transfer cannot guarantee a single-child pregnancy. This is because some embryos can "separate" abnormally and result in identical twins. Overall, though, a single embryo transfer will result in a reduced chance of pregnancy per embryo transfer compared with transferring two or transferring multiple embryos, but this decision will significantly reduce the risk of pregnancy by avoiding multiples.
Accordingly, before deciding to transfer single embryos, fertility doctors will prioritize selecting patients who are considered to have a high chance of pregnancy with favorable predictors (good embryo quality, no smoking, etc.) , normal body mass index, previous successful pregnancy,...). Conversely, for patients with a more complex clinical situation and multiple risk factors for success, more embryo transfer may be recommended.

The desired outcome of infertility treatment is the birth of a healthy baby and the decision about how many embryos to transfer should always be well thought out. As a multiple pregnancy is associated with higher morbidity and mortality, furthermore, as in vitro fertilization techniques continue to improve the implantation potential of each transferred embryo, performing embryo transfer Single embryo transfer is preferred over multiple embryo transfer. This will reduce the risk of multiple pregnancies as well as increase the probability of having a healthy baby.
Ideally, when intending to artificial insemination, you and your wife need to go to quality medical facilities to be examined by a doctor and have the necessary advice for embryo transfer.

Currently, Vinmec Fertility Center is the address for infertility treatment - infertility is chosen by many couples, when this is the leading modern center in Vietnam built, applying the combined treatment process. Comprehensive examination, combining both obstetrics and gynecology.
Always at the forefront of quality, the team at the center are all leading doctors and experts in the field of obstetrics and gynecology in the country and internationally. With a high level of expertise and modern equipment and machinery, infertile couples have achieved a high success rate in each embryo transfer and realized their dream of becoming a parent.

References: fertstert.org - fertilitymemphis.com