Single or Multiple Embryo Transfer?

April 15, 2019

The health hazards of multiple pregnancy:

https://www.focusonreproduction.eu/article/ESHRE-Meetings-BOEA-Multiples

I am glad to read this publication and wanted to share it with you. I strive every day to convince patients that transferring only one embryo at a time is the best option for them, and for their unborn child. I always go back to nature to explain the reasons. Women’s uteri and their bodies were designed to carry only one baby at a time. If you put two babies at a time inside her womb, the chances of a mother’s uterus and their body being able to withstand a pregnancy for nine months is lower than if you only put one baby. This is the reason that many studies show that twins have a 10 time greater chance of negative birth outcomes, sequelae, for the rest of their life!

Then why do we insist on transferring two embryos? Well some years ago, our freezing techniques were far from optimal. At that time, by freezing an embryo we were decreasing their chances of implanting by 50%! We were terrified of transferring a “bad” embryo and freezing a “good” one, in turn dropping the couple’s chances of conception drastically. This has changed now. Our freezing techniques are so good that many studies are showing that transferring frozen embryos is as good if not better than transferring fresh embryos. There is no reason for transferring two embryos now! Studies dating back to 2010 show that transferring a single embryo is the way to go, so this is not new: most Scandinavian countries adopted this policy many years ago.

It is really worrying to see that in Ireland, some clinics still recommend transferring two embryos. What even worries me more is that some gynaecologists think that twins are actually good news! In spite of all fertility societies pushing strongly toward single embryo transfer, the outdated policy of more is better still persists in some clinics.

In ReproMed we transfer one embryo in more than 90% of patients. With this policy we have achieved a 67% pregnancy rate. We strongly believe that transferring 2 embryos is only putting you and your children at risk. This is not something new, this is knowledge that has been available for the past nine years.

There has to be a change in approach in our field, starting with the education of patients, but especially a more responsible approach by fertility doctors, for which my team at ReproMed will continue to advocate.

Dr Hans Arce

Medical Director ReproMed Ireland

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