The Embryo Transfer is the final step of the IVF process, and one of the most important ones. Very often, if the Ovarian stimulation protocol was correctly prescribed, and the women reacted suitable to the stimulation phase, we obtain more than one good embryo for the final transfer (if there was not an issue with the maturation of the eggs and motility of the sperm).
The success of one IVF cycle depends mostly on the number & quality of eggs we are able to retrieve after the stimulation phase and the number & quality of embryos that resulted from the IVF cycle.
We as a fertility team are always happy if we have more available embryos from which our patients can choose. More embryos give us the chance to really pick the most quality one(s) for the final embryo transfer.
On the other side, multiple choice of high-quality embryos quite often brings another factor in the game. The dilemma if to transfer one or multiple embryos.
There are many discussions within the IVF medical and social circles about the number of transferred embryos. In certain situations, transferring multiple embryos gives a higher chance of pregnancy, in other, it represents a higher risk. Also, different countries have different guidelines and regulations about the maximum number of embryos that can be transferred.
So, if you are on the path to pregnancy with the help of IVF, and you might have this dilemma, continue reading this blog. We would like to “clear the air” a bit for you.
Single vs Multiple Embryos
Transferring a single embryo is the most common practice within the fertility treatment circles.
The main goal of the IVF treatments is to result in a healthy pregnancy, and a healthy baby(babies). The transfer of multiple embryos inevitably leads to multiple births or having twins, but it also comes along certain challenges and opens the potential for complications under certain circumstances. So, let’s dig into them.
What factors are considered when making a decision about one or multiple embryo transfer?
Your preferences are always taken into consideration by our fertility team. But, sometimes, the medical expertise or certain medical regulations and protocols might go against your decision.
Before even thinking of any of the options, you have to obtain a consultation with a fertility expert. The fertility doctor will create a suitable IVF program for your fertility evaluation and focus more or less on a certain problematic area.
The number of embryos is decided at a later stage in the IVF treatment, but in some cases, the number of embryo transfers can be defined since the beginning. Usually, the first guideline that we as a fertility clinic have to respect is the country regulations about the maximum of embryo transfers.
Legal regulations
Most EU countries have set a legal limit on the number of embryos transferred in a single cycle. In Austria and Belgium, patients under 36 can have 1 to 3 embryos transferred. Most recommended is the transfer of 2 embryos for women under 37. Many limits as in the UK or Netherlands are age-dependent, though one is the most preferred solution. France and Sweden have a strict limit of 2 embryos transferred, no matter the age.
In Cyprus, the regulations differ. In South Cyprus, the limit is 2 embryos. In North Cyprus, the maximum amount of transferred embryos is 3 and is not defined by age.
So, if you are interested in undergoing IVF at euroCARE in Northern Cyprus, if we don’t detect any reasons that will indicate multiple pregnancy complications, we can transfer up to 3 embryos.
Medical conditions and age
While the transfer of multiple embryos can increase the chance of successful implantation, you should definitely have single embryo transfers if you:
- Have a favorable prognosis for an IVF treatment
- You are at the age of 38 years or younger
- Have good quality eggs and embryos
- It is your first IVF treatment
- You want to avoid the risk of multiple pregnancies
When should you consider multiple embryo transfers?
You may want to transfer two or more embryos if you:
- You are older than 38
- You’ve had several IVF failed cycles before
- Have an unfavorable prognosis for IVF
- You are interested in twins
What are the most common challenges deriving from multiple births and why is it important to beware of them?
Struggling with infertility is the biggest challenge that people reaching to IVF usually have. People who reach IVF usually have a very vulnerable reproductive system, therefore, is very important to take into consideration all the risks that might occur on the path to pregnancy.
The most common reason for a multiple embryo transfer is getting pregnant with twins, or triplets. This is absolutely possible with a suitable IVF treatment, and in 90% the result is a healthy pregnancy and kids. The only risk is preterm birth.
In the couples pregnant with twins, there is a 60% chance of preterm birth. When speaking about triples, the percentage of preterm birth is reaching almost 90%.
Pregnancies with twins, no matter if naturally conceived or with the help of IVF, are exposing the mothers to maternal complications twice as more as pregnancies with one child. Usually, they are specific by premature birth and more vulnerable infants with lower weights.
The more babies the woman carries, the higher the chances of complications during pregnancies are. Although this doesn’t have to be the case in all women, it is nice to be aware of the risks when making the most important decision when undergoing an IVF treatment.
What can be improved with the current technologies available in reproductive medicine?
A critical factor taken in the evaluation of IVF’s success is the implantation rate. The implantation rate is defined as the proportion of transferred embryos that actually implant to the woman’s uterus lining and furthermore, result in fetal heartbeats. To increase the implantation rates is one of the main missions of assisted reproductive technologies and medical advancements in this area.
Implantation rate increase with IVF treatments
As the fertility in both female and male partner is quite harmed by age, the implantation rates also have been found depending on their age. In addition, the egg and sperm quality can affect the embryo quality and potential for proper development, and most important the embryo ability to implant.
For example, embryos who developed from the reproductive material of partners in more advanced reproductive age (>40) might have an implantation rate of 10 – 15%. Women and men in their 30ies have been associated with higher embryo implantation rates of 40-50%.
The implantation rate can, therefore, be significantly increased if couples in more advanced reproductive age would undergo an IVF with Donor’s eggs or IVF with their own frozen reproductive material, that was taken at the peak of their fertility.
The medical advances that IVF made available, such as Genetic Screening of the embryos can increase the implantation rates to 70-80% or even greater.
Birth rate increase thanks to IVF
Thanks to these enhancements helping the implantation, the premature births of multiples at the 26th week have approximately 80% of survival rate.
How can euroCARE contribute to successful IVF treatment, both with single or multiple embryo transfer?
During this decade, since we’ve started in North Cyprus, our list of treatments and assisting technological enhancements have been constantly enriching. We have met with patients struggling from almost each infertility cause, and also patients with many different preferences about the number of embryos to transfer.
Our treatments can differ based on each patient’s personal case. We are keeping the main and standard IVF procedure for everyone, but the ovarian stimulation protocols vary, the usage of additional treatments varies, and especially the number of embryos transferred.
We keep maximum monitoring of each step of the IVF process. Since your fertility evaluation we take care that everything we do, we do aiming to get more quality eggs, more eggs for fertilization and of course, top-quality embryos for transfer.
At our clinic today you can undergo:
- Standard IVF with ICSI / IMSI
- IVF with Egg/Sperm Donation for those where poor reproductive material quality was detected
- Tandem IVF
- IVF with PGD or PGS
- IVF with Cryopreservation for those who want to preserve their fertility, or had several high-quality embryos remaining after the final transfer
To increase your chances of successful implantation of the embryo we can also add the following additions to your IVF cycle:
- Assisted hatching
- Embryo Glue
- Blastocyst transfer
What we are very proud of is being able to perform upon your request the Preimplantation Genetic Screening and Diagnostics of the embryo. These two cutting-edge technological enhancements that enable our clinic to perform embryo screening and increase your chances of successful pregnancy!
EuroCARE Team is here for you!
Connect with our team and share your struggles with us. We would patiently listen to your story and provide you with the most favorable and affordable option for you.
The IVF success rates of euroCARE IVF are a strong indicator of our strong dedication to help couples improve their chances of getting pregnant, and help them get pregnant with a wide range of low-cost IVF treatments.
You are only a step away from getting free consultations with one of the best IVF doctors in Cyprus!
Resources:
https://www.fertilityiq.com/topics/embryo-transfer/the-risks-and-benefits-of-single-and-multiple-embryo-transfer
https://www.losangelesreproductivecenter.com/blog/2018/11/29/single-vs-multiple-embryo-transfer-195153