Carolina Conceptions: Our Embryo Transfer Guidelines

The recent birth of octuplets in California after an IVF procedure has been the topic of much media coverage and yet remains cloaked in secrecy. No definitive statement or explanation has been provided by the California clinic responsible for the procedure. Reports suggest that at least 6 embryos were transferred into a 33 year old fertile woman with six prior deliveries. Outcomes such as this appropriately concern infertile couples seeking expert fertility advice. We at Carolina Conceptions would like to discuss this case with you and explain the guidelines that we use in deciding upon the number of embryos to transfer.

IVF is one of the most controlled procedures in fertility therapy. With IVF, the number of embryos that are transferred, or placed back into the uterus, are part of a decision and discussion between the physician, embryologist and the couple. The American Society for Reproductive Medicine (ASRM) provides guidelines based on age of the woman, as age is the most predictive determining factor in the success of IVF. Younger women have better oocyte (egg) and embryo quality and therefore should have fewer embryos transferred to prevent higher order multiple births (triplets and more). In young women under the age of 35, ASRM recommends the transfer of only two embryos. We at Carolina Conceptions agree with this recommendation and routinely transfer only two embryos in women under age 35. Factors that influence this decision, however, include prior fertility history, prior failed IVF cycles, cleavage stage of the embryos (8-cell embryos or blastocysts) and embryo quality. Some couples who are young with excellent embryo quality sometimes choose to transfer only one blastocyst 5 days after egg retrieval. Although we welcome the opinion of the intended parents, physicians at Carolina Conceptions would not be willing to transfer a number of embryos that we feel would result in a multiple birth that could be dangerous to the mother and intended infants.