Pregnancy at what cost? IVF expert warns against risks of multiple embryo transfers

Transferring 2 embryos may boost pregnancy chances but here’s the catch: What IVF doctors want every woman to know.

Embryo transfer is a crucial step in the process of IVF (In Vitro Fertilization). One IVF cycle includes oocyte pickup (egg retrieval), injecting the mature eggs with sperm to form embryos and culturing those embryos in the lab for 3–5 days. Placing these embryos back into the woman’s uterus is known as the embryo transfer procedure.

Single vs multiple embryo transfer: The IVF truth that no one tells you until you’re already in it.(Image by Unsplash)

In an interview with HT Lifestyle, Dr Aparna N, consultant fertility specialist at GarbhaGudi IVF Centre, shared, “It is the final and most critical step in the IVF cycle which is done in sterile conditions inside the embryology OT. The best quality, one or two, embryos are selected for transfer. Following this, the implantation stage occurs, during which the embryo attaches to the uterine lining and begins to develop into a healthy foetus.”

 

For each embryo transfer done during an IVF cycle, where a woman’s own eggs are used, chance for a baby is around 40% in her late 20s, around 30% until late 30s, and around 10–15% till the age of 43. (Shutterstock)

 

How do doctors decide on the number of embryos to transfer?

Frozen embryo transfer allows a woman’s ovary to recover from ovarian stimulation during in vitro fertilisation and also gives time for her exposed endometrial lining to shed. (Shutterstock)

If it’s a day 3 embryo, i.e., if we have cultured the embryos for three days, the chances of implantation are 20 to 25 percent. We put 2 or 3 embryos in this case. For embryos that are cultured till the 5th day, i.e., the blastocyst stage, where there is more potential for pregnancy which is about 40 to 50 percent, there we can opt for one or two embryos for transfer.

• Patient’s age

If the patient is less than 35 years, we can transfer only a single embryo. In women above 35 years we can transfer up to two embryos. If women have any health issues, then we restrict it to single embryos because multiple pregnancies might lead to complications.

If the couple already has a child, to prevent multiple pregnancies we give the option of single embryo transfer.

• Co-morbidities

If the woman has a small uterus(unicornuate/ only one half of the uterus has developed), previous history of uterine surgeries, recurrent mid trimester pregnancy losses, mild cardiac problems, etc then we go with single embryo transfer. We assess all the above factors to arrive at a decision.

• If the embryo is genetically tested (PGT testing) then we consider single embryo transfer. The probability of twin pregnancies, when we put two embryos, is up to 20-30% which is 10 times higher than the natural conception. Hence, many IVF specialists are moving towards single best embryo transfer to prevent multiple pregnancy and its complication

Tips to follow

Dr Aparna N suggested:

• Many assume that women have to be under complete bed rest after embryo transfer. This is a myth because doctors will not recommend complete bed rest. We advise them to do restricted activities that have lesser physical strain. The routine day-to-day activities like cooking and walking can be continued. We usually suggest avoiding long-distance travel, strenuous activities, weight lifting, etc.
• Eat a healthy diet; indulge in relaxing activities such as meditation.
• Take your medications regularly.
• If there are any signs such as spotting, pain, etc., immediately inform your doctor.
• Do not self-medicate.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.