How many embryos should you transfer during an IVF cycle?

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Q:

How many embryos should I transfer?


A:

Because of age-related changes in fertility, the number of embryos transferred is directly related to the age of the mother or egg donor. There is a balance to strike between achieving a pregnancy and reducing the chances of high-order multiples— triplets or more.

The number of embryos transferred should be decided under the guidance of the individual’s doctor. When deciding how many to transfer, your doctor will take the following into account:

  • The age of the female partner or egg donor
  • The stage at which the embryos are transferred
  • The quality of the embryos
  • The number of embryos available
  • The woman's history and diagnosis
  • The outcome of previous treatments

The American Society for Reproductive Medicine (ASRM) has set guidelines for the number of embryos to transfer, depending on age and situation. These are not laws, but they are used to help counsel patients.

It is possible that more than the recommended number of embryos can be transferred depending on the specific circumstances of each case. There are no guidelines for women over the age of 42.

Recommended Limits for Embryo Transfer by Age

Prognosis
Under 35
35-37
38-40
41-42
Cleavage-stage embryos (Day 3)
Euploid
1111
Other favorable*
1
1
≤1
≤1
All others
≤ 2
≤3
≤4
≤5
Blastocysts (Day 5)
Euploid
1111
Other favorable*
1
1
≤2
≤3
All others
≤2
≤2
≤3
≤3

Source: ASRM

≤ means less than or equal to the number listed

*Other Favorable conditions include any one of these criteria:

  • Fresh cycle: expectation of 1 or more high-quality embryos available for cryopreservation, or previous live birth after an IVF cycle.
  • FET cycle: availability of vitrified day-5 or day-6 blastocysts, euploid embryos, 1st FET cycle, or previous live birth after an IVF cycle.

All other (less-favorable ) conditions include any other situation.

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Dr. Rebecca Matthews has a PhD in embryo implantation and currently works as an embryologist. Rebecca is passionate about her work and about educating and empowering people to take control of their own healthcare decisions. With this in mind, she has written an IVF guidebook to help patients understand the processes and options involved in fertility treatments. Her book, IVF: A Patient's Guide, can be found on Amazon.

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