How Many Embryos Should You Transfer: All Ages

Ideally it is best to transfer only one embryo at a time. Pregnancy rates are higher than ever with IVF, but twin pregnancies are still a very high risk. In addition, IVF embryos are more likely to split than naturally conceived embryos, one embryo can become 2 in about 2% of IVF cycles – so putting in more than 1 embryo could lead to triplets or more!

More and more data supports the transfer of only one embryo at a time in patients less than 40, in people of any age using an egg donor and people of any age transferring an embryo that has normal chromosomes via PGT (Preimplantation Genetic Testing). In fact, numerous presentations at the ASRM meeting this year (The Annual Meeting for the American Society for Reproductive Medicine) demonstrated that in these circumstances, you end up with more healthy babies and significantly less complications if you transfer only one embryo at a time.

So, are there times when you should consider transferring more than one embryo? Yes!

First of all you need to feel comfortable, so even if your doctor recommends transferring more than one embryo you should never feel obligated to do anything you do not understand thoroughly. Having said that – there are many times when transferring more than one embryo can make sense.  If you are over 40 and you have untested embryos, it may make sense to transfer more than one embryo.  If embryos are early stage embryos – 2 or 3 days old, rather than blastocysts that are 5 to 7 days old – it might make sense to transfer more than one even if you are less than 40 years old. In general, these recommendations are based upon risk benefit calculations – will transferring more than one embryo increase your chances of a successful pregnancy without putting you or your pregnancy at significantly higher risk for complications?

Your doctor knows you and your situation best and can help you make these calculations. Ultimately how much risk you want to take is very personal, so even if your doctor feels the risks are reasonable, this is your body and your family – so you have the final word!

For more information about embryo transfers or your fertility health, please reach out. You can find us via our contact us form, at our social handles or by calling 973.548.9900. We look forward to empowering your fertility journey.

Serena H. Chen, MD serves as Director for the Division of Reproductive Medicine in the Department of Obstetrics and Gynecology at Saint Barnabas Medical Center, and the Institute for Reproductive Medicine and Science, and is a Clinical Associate Professor at Rutgers, UMDNJ Medical School and the St George’s University School of Medicine.

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