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Can 2 embryos be transferred?

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3 fertility expert(s) answered this question

Answer from: Raúl Olivares, MD

Gynaecologist, Medical Director & Owner Barcelona IVF
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The number of embryos that can be transferred is usually limited in certain countries. That depends on the regulations. In Spain, the law allows us to transfer a maximum of 3 embryos. We can transfer 2, though, we usually recommend transferring one unless we have any issues with the quality of the embryos or the risk of having a twin pregnancy because the woman’s age is more advanced – we may consider transferring two. There is no problem with that.

I’ve also heard of different techniques done in certain countries where they are transferring embryos on day-3, and then again, on day-5, sometimes even on day-4. For me, that does not make any sense, it lacks any scientific evidence that proves that this kind of practice is really useful.

The idea is that you must take all the embryos to day-5, and then depending on each individual case, assess the risk of having a twin pregnancy. Based on that and on what the patient wants, transfer one or two blastocysts.

Answer from: Alpesh Doshi

Embryologist, Consultant Embryologist and Co founder at IVF London
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It can be transferred by the law of this land up to two embryos. Can be transferred in women under the age of 40 and up to three embryos can be transferred in women over the age of 40 but age is not the only parameter to determine whether you put three embryos back. There has to be additional reasons for a clinic and a patient to decide to go for three embryos so, for example, you cannot have a patient whose first IVF cycle is 40 and a half years old and she says I want three embryos. No, the rule is still potentially only up to two embryos unless a patient in her 40s has had six or seven IVF cycles and then, we can say that this is an exceptional reason for her to have three embryos put back but again, nowadays I must say that, in women over the age of 40, we tend to recommend more genetic screening of embryos and then still putting one single embryo back, because no one wants to take the risk of multiple pregnancy, especially in women over the age of 40 where the risks of miscarriage are also higher due to age. I know I have seen a triplet at 43 years of age as well and and gone those days are now. We should not be putting three embryos back as a matter of rule. We should be trying to use technology at its optimum stage in order to select the best embryo. In order to give the patient the best chance of pregnancy and a live birth.

Answer from: Harry Karpouzis, MD, MRCOG, DIUE

Gynaecologist, Founder & Scientific Director Pelargos IVF Medical Group
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The number of embryos that we transfer during IVF needs to be discussed, it’s a decision between the couple and the doctors.
That also depends on the regulations and laws in each country. In Greece, you can transfer 2 embryos, of course, in some cases, if the quality of the embryos is not so good and the age of the woman is over 35, by transferring 2 embryos in comparison to transferring one, the chances of success increases. In Greece, the law sometimes allows transferring even 3 or very rarely 4 embryos in women with recurrent failure implantation who are over 40-42 years old.

By transferring 2 embryos, you increase the chances of having multiple pregnancies, which is a higher risk of pregnancy, and it can cause problems like prematurity, low birth weight, it can also increase the risk of diabetes or hypertension. All those things need to be discussed with the couple before we perform the embryo transfer. If a woman is less than 35 years old, and she has a top blastocyst, then the best thing for her would be to minimize the risk of multiple pregnancies by doing a single embryo transfer. If a woman had unexplained failed attempts before and is more than 35 and the embryo quality is poor, then there is a benefit in transferring 2 embryos unless the couple says they do not want to have twins, it is best to transfer only 1 embryo.

About this question:

Is it possible to transfer 2 embryos?

At some point in your IVF journey, you will start wondering how many embryos should be transferred during an IVF cycle. If you’ve been trying to get pregnant for some time already, you probably want to increase the chances, but does transferring two embryos really increase the chances? What is the difference in success rates? Is one option better than the other?

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