Yes—we’re still talking about this…. How many embryos to transfer?

One of the hardest decisions many hopeful IVF parents make is how many embryos to implant.  Well, in 2013 some fancy committees proposed some criteria for number of embryos to transfer:

http://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Guidelines_and_Minimum_Standards/Guidelines_on_number_of_embryos%281%29.pdf

Helpful!  Here’s their suggestion:

	<35	35-37	38-40	41-42
Day 2/3 embys - favorable	1-2	2	3	5
Day 2/3 embys - other	2	3	4	5
Day 5/6 blasys - favorable	1	2	2	3
Day 5/6 blasys - other	2	2	3	3

“Favorable” is defined as first cycle of IVF OR good quality embryo OR excess embryos available to freeze OR previous successful IVF attempt.  For patients with two or more failed fresh IVF cycles, or a “less favorable prognosis,” one additional embryo may be transferred.  For women >43, there is insufficient data to recommend the number of embryos to transfer.  For donors under 35, a single embryo should be used.  The recommendations for frozen are the same for fresh.

So this would have suggested one embryo transfer with my first kid, which is what we did and what obviously worked.  But for my second round, it would have suggested two each time, which would have been the right result since none of those blastys (except the crappy still-frozen one, maybe) were viable.  We (stubbornly?) decided to do continue to do a SET (single embryo transfer) for our FIFTH round.  Obviously if this does not work and we have any “genetically normal” ones from our genetic testing, we will continue to implant single embryos.  We just have to wait and see!