Rita Bakshi, Sr. Gynaecologist & IVF Expert, RiSAA IVF talks about the factors which healthcare providers should carefully consider when deciding on the number of embryos to transfer to strike a delicate balance between the desire for a successful pregnancy
In-vitro fertilisation (IVF) has revolutionised the field of reproductive medicine, offering hope to couples struggling with infertility. While the procedure significantly increases the chances of achieving a successful pregnancy, it also comes with the potential for multiple pregnancies, such as twins or more. However, doctors, aware of the associated risks, employ a strategic approach to minimise these by carefully deciding the number of embryos to transfer.
Understanding IVF and multiple pregnancies
IVF involves combining eggs and sperm outside the body, leading to the formation of embryos that are later transferred into the woman’s uterus. The success of IVF is often measured by the rate of implantation, where embryos attach to the uterine lining, resulting in a viable pregnancy. However, a common concern associated with IVF is the increased likelihood of multiple pregnancies due to the transfer of more than one embryo.
Factors influencing embryo transfer decisions
To strike a delicate balance between the desire for a successful pregnancy and the need to minimise the risks associated with multiples, healthcare providers carefully consider various factors when deciding on the number of embryos to transfer.
Age of the woman
Women’s fertility decreases with age, and older women may require a higher number of embryos to be transferred to enhance the chances of successful implantation. However, this increases the risk of multiple pregnancies.
Embryo quality
The quality of embryos plays a crucial role in the success of IVF. High-quality embryos are more likely to implant successfully, allowing for the transfer of fewer embryos and reducing the risk of multiples.
Fertility history
Couples with a history of unsuccessful fertility treatments or recurrent miscarriages may be recommended to transfer a higher number of embryos to improve the likelihood of success. However, this decision must be balanced against the risk of multiples.
Strategies to reduce the risk of multiple pregnancies
Healthcare providers implement several strategies to reduce the risk of multiple pregnancies during IVF:
Single Embryo Transfer (SET)
Single embryo transfer involves transferring only one high-quality embryo into the uterus. This approach significantly lowers the risk of multiples while maintaining a reasonable chance of successful implantation.
Elective Single Embryo Transfer (eSET)
In cases where multiple embryos are available, eSET involves selecting the most viable embryo for transfer. This approach allows for the achievement of a successful pregnancy while minimizing the risk of multiples.
Culture and blastocyst transfer
Extended embryo culture to the blastocyst stage allows healthcare providers to assess embryo quality more accurately. Transferring fewer embryos at this stage reduces the risk of multiples without compromising success rates.
In conclusion, while IVF has become a beacon of hope for couples facing infertility, the risk of multiple pregnancies is a concern that healthcare providers actively address. By carefully considering factors such as the woman’s age, embryo quality, and fertility history, doctors can make informed decisions about the number of embryos to transfer. Strategies like single embryo transfer and elective single embryo transfer have proven effective in reducing the risk of multiples while maintaining high success rates.
As advancements in reproductive technologies continue, the field of IVF evolves, offering couples increasingly sophisticated options to build their families. Open communication between patients and healthcare providers is crucial in navigating the complexities of IVF, ensuring personalised and informed decision-making for the best possible outcomes.
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