We routinely see that many IVF clinics will transfer two, three, and even four embryos back into patients at the end of the IVF cycle. This is completely inappropriate , because we all know that the best live birth rates are achieved by transferring a single embryo at a time – after all, that’s what nature intended !
So why do clinics continue doing this? This is because IVF clinics are so focused on artificially boosting their clinic’s success rates by getting patients pregnant by hook or crook, that they don’t think about the long term harmful consequences of transferring more than one embryo at one time.
When doctors transfer two or three embryos at one time, they tell the patient this is the best thing for them to do , because it will maximize their chances of getting pregnant. And patients are quite happy to listen to the doctor, because they go to the IVF clinic to get pregnant. But the reality is that even if they do get pregnant after transferring more than one embryo, this increases the risk of their ending up with a multiple pregnancy. Now it’s true that the more embryos you transfer in one cycle, the better the chances of getting pregnant in that cycle, but there is a price to pay by doing this . For example, these patients will often not have any frozen embryos left for future transfers, and if the cycle fails, they will have to start a fresh cycle all over again ! Which is good for the doctor, because he can charge more money, but bad for the patient. If the doctor transfers more than one embryo, and 2 implant, the patient ends up with a twin pregnancy. Now a twin pregnancy seems like a very desirable outcome for many patients , because they feel they have got a bonus – an instant family – two kids for the price of one ! They start dreaming about dressing up their kids in identical clothes, and how cool they will look, so that they will be the cynosure of all eyes !
But the reality is that a twin pregnancy is high risk and complicated , because they are at increased risk for miscarriages ( when they lose the entire pregnancy), and preterm birth ( when many of these babies will end up handicapped ) !
Both obstetricians and paediatricians will tell you that twin pregnancies can be nightmares , because many of these babies are born prematurely, and up spending weeks in the NICU ( neonatal intensive care unit ) as preemies. And this can be heartbreaking for the parents , because the babies are so helpless and there’s nothing they can do. And many of these babies will have multiple handicaps, while others will die. You can imagine the amount of trauma that this causes to parents because though they got pregnant with the IVF treatment, they ended up with empty hands, because they lost their baby because the baby was too premature. And even though other premature babies do survive, they will be left with many physical and mental disabilities ( such as retinopathy of prematurity and cerebral palsy), a life-long deficit which means they will actually become a burden.
This means that in order to achieve the short-term goal of increasing their IVF pregnancy rates, these IVF doctors are being irresponsible, and put their patients at risk for long-term losses. And unfortunately, patients are not educated or well-informed enough to understand this risk. This is why if you are told to transfer more than one embryo, please treat this as a red flag , because this needs to be an exception and not the rule. Try to find a doctor who follows global best practices, and does only single embryo transfers at the blastocyst stage.
The real reason many doctors put back so many embryos at a time is because their embryology lab is not good, and they don’t have enough confidence in its ability to grow embryos to Day 5, which is why they transfer lots of embryos back on Day 3, with the hope that at least one will stick ! They feel their job is done, especially when the patient gets pregnant , because they treat this a success , as far as the IVF clinic statistics go.
But unfortunately, IVF specialists do not monitor the patient’s pregnancy, let alone live births. And as an IVF patient , all you care about is having a healthy baby ! Now many IVF clinics only care about bumping up their IVF success rates , and these two are very different. Just getting pregnant doesn’t mean that you will end up with a healthy baby ! The problem is that the joy patients get when they find they are pregnant with twins is short-lived when they develop a complication during their pregnancy . But the IVF doctor has now washed his hands of all responsibility because he has done his job of getting you pregnant and can add you to his IVF pregnancy statistics, so he doesn’t care about the final outcome I
This is why you need to be proactive , and any doctor who pushes you to transfer more than one embryo at a time is giving you bad advice, so please treat this as a red flag. If they transfer one embryo at a time, it’s true that your chances of getting pregnant in that particular cycle will be less as compared to transferring two or three at a time, but your cumulative conception rate will be higher , because you will have more embryos to transfer in future cycles , because these spare embryos will be frozen . Transferring frozen embryos has a higher success rate, and is much less expensive than starting a fresh cycle , as a result of which your live birth rate will definitely be better than putting more embryos back at one time.
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