The IVF Dilemma: Optimizing Pregnancy Rates, Minimizing Multiples

One of the challenges in reproductive medicine is giving patients the best chance of conceiving while avoiding multiple births. After all, it is our experience that singleton births are the healthiest for both baby and mother. However, with an IVF cycle, fertility clinics typically transfer multiple embryos to give patients the greatest chance of conceiving…a practice that can result in multiple births. (This is quite different than natural fertilization wherein one embryo is fertilized during a natural cycle.) Thankfully, fertility clinics are making use of state-of-the-art techniques such as embryo freezing and the day 5 embryo transfer to help address this dilemma. With regard to embryo freezing, patients can avoid multiple pregnancies by transferring fewer fresh embryos and successfully freezing the remaining embryos. The frozen embryos can be thawed and transferred at a later date should the patient choose to have another IVF cycle.

Additionally, performing the day 5 embryo transfer as opposed to the standard day 3 embryo transfer enables us to assess which are the most chromosomally normal embryos as well as those most likely to develop in the womb following embryo transfer. Subsequently, fewer embryos are transferred (minimizing multiples). We are also seeing a small but growing number of couples interested in the day 5 transfer of only one embryo because they wish to avoid the risks of having a twin pregnancy. In fact, there is a recent article on use of single embryo transfer to help reduce multiple births. The article can be read here. These procedures are not appropriate for all patients and we encourage you to speak to your physician or drop me a line to discuss your individual case.

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