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Archive for April, 2010

So you’ve gone through the entire IVF cycle, jabbing yourself with needles several times a day. Dragging yourself to your doctor’s office for what seems to be a dozen visits and blood draws.  You survived the egg retrieval and are still a bit sore and bloated.  You’ve anxiously awaited word from the clinic for the fertilization report the next morning. but now you’re past that. Now it is time to go to the clinic for your embryo transfer. Then it hits you, more than it has in the past, that you have to decide how many embryos you are actually going to have transferred.  You’ve thought about it before, even had discussions with your doctor, but suddenly the risk of getting pregnant with twins or triplets or not getting pregnant with a single embryo transfer seems much less of an abstract risk.  You ask yourself, “Am I making the right decision?” What is the “right” decision? What is the magic number?

The good news is that in the United States the decision of how many embryos to transfer is left to the patient and her doctor.  That’s not so in many European countries…however the costs are less in other countries.  The risks and expense of pregnancies with multiples is used as a rationale for limiting, by law, the number for embryos that may be transferred in other countries.

Since they have gotten better at IVF the number of high order multiple (HOM) pregnancies have decreased.  Before the success rate was only 15-20% so doctors would often transfer three, four or five embryos in the hopes that one would stick.  This resulted in not many getting pregnant but the ones that did had multiples.

So back to the original question….there is not one number that is right for every patient, and this should be an individualized decision.  There are guidelines however which states the greater your chance of pregnancy the fewer embryos you should have transferred.  Three main factors are: 1) age, 2) stage of embryo development, and 3) prognosis. The guidelines are strongly encouraging transferring only one embryo in those felt to have the highest chances for success.

So I wish I could be more specific in my answer but the bottom line is discuss your success rates with your Dr. and multiple pregnancy rates for that specific clinic. Sometimes it will be more clear and other times it will be more difficult.

Good luck to you all!

Source : Resolve.org Dr. Frederick Larsen

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