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Infertility & Reproduction Health Center

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IVF: Are 3 Embryos Too Many to Transfer?

No Justification for More Than 2, Study Finds
WebMD Health News
Reviewed by Laura J. Martin, MD

Jan. 11, 2012 -- Transferring more than two embryos during an IVF cycle is a dangerous practice that does not improve a woman’s chances of delivering a baby, a European study finds.

Researchers analyzed close to 125,000 in vitro fertilization (IVF) cycles performed in the U.K. over a five-year period in one of the largest studies ever to compare outcomes in women younger than 40 to those of older women.

The conclusion that there is no medical justification for transferring three or more embryos, even in women over the age of 40, has major implications in the U.S., where 1 in 3 IVF procedures involves the transfer of more than two embryos.

3 Embryos: 1 Too Many?

While that represents a decline from a decade ago, when closer to 2 out of 3 IVF procedures in the U.S. involved three or more embryos, there is still plenty of room for improvement, a study co-author says.

“The practice of transferring multiple embryos is very much market-driven in the United States,” says Scott M. Nelson, MD, PhD, of the University of Glasgow Centre for Population and Health Sciences. “There is an economic incentive for transferring more embryos in the U.S., but no sound medical reason for doing so.”

New York infertility specialist Glenn L. Schattman, MD, disagrees. Schattman is president of the Society for Assisted Reproductive Technology (SART).

SART guidelines call for the transfer of one or two embryos per IVF cycle in younger patients with the best prognosis, and as many as four embryos per cycle in patients in their late 30s and 40s with a poor chance of achieving a pregnancy.

He says it is clear from SART’s own statistics that the poorest-prognosis patients have a much better chance of having a baby when more than two embryos are transferred.

“There is a continuous and constant decline in fertility with increasing age, so it makes no sense to treat a 39- or 40-year-old the same way we would a 26-year-old,” he says.

Lower Birth Rates Seen With 3 Embryos

The 124,148 IVF cycles analyzed by Nelson and colleague Debbie A. Lawlor, PhD, of the University of Bristol, resulted in 33,514 live births.

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