In the U.S., the practice guidelines published by the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) provide recommendations on how many embryos to transfer in order to balance safety with the effectiveness of assisted reproductive technology. In an effort to reduce multiple births and associated complications, it is important to evaluate embryo transfer practices that contribute to these outcomes.
Tag: embryo transfer
8 Things We Learned From Octomom
Dr. Edward Dourron / For THE CURRENT
A year ago, the Medical Board of California revoked the license of Dr. Michael Kamrava, finding he “did not exercise sound judgment” in transferring 12 embryos to Nadya Suleman, who already had six children at home. The ruling, while not surprising, was illuminating, and it’s worth reflecting on the eight things we learned from Octomom:
1. Know How to Say No: There is a point where physicians have to make a judgment call. Pregnancies with triplets – let alone eight infants – put the mother at high risk of serious medical complications and put unborn children at risk for developmental disabilities. Doctors need to rely on their professional expertise and experience to know when to turn a patient down.
2. Beware the Patient with Tunnel Vision: Often when a patient comes to a fertility doctor, unsuccessful pregnancy attempts have made her anxious and determined. She might want to get pregnant even if she has underlying conditions that could put her or her baby at risk. Doctors have learned to be vigilant about preconception counseling and medical testing to determine whether patients are healthy enough to pursue pregnancy.
3. Less is More: In 1999, 35 percent of all transfers involved four or more embryos. In 2009, only 10 percent had four or more. And those high-number transfers are generally reserved for patients with significant fertility challenges. In contrast, Octomom already underwent multiple successful IVF (in vitro fertilization) procedures and had given birth to six children when she had her 12-embryo transfer.
4. Less is Sometimes Really More: Single embryo transfers are gaining popularity. Why? During IVF, the rate of monozygotic (identical) twinning is 10 times the rate in nature. Though Octomom didn’t experience this, it is not uncommon for a single embryo transfer to result in twins – or a double transfer to become quads.
More choose single-embryo transplants for IVF
As in vitro fertilization has become an increasingly common fact of life for those seeking to start a family, so have twins, triplets – or more, thanks to the transplantation of multiple embryos. The CDC reports that the twin birth rate rose 76 percent from 1980 to 2009 while triples and higher-order multiple births rose a whopping 315 percent.
But the tide of multiple births may be ebbing as an increasing number of women are opting to transfer a single embryo during IVF.
According to experts, women usually have two or more embryos transplanted in order to boost the chances for a baby. (In the rare case of “Octomom” Nadya Suleman, eight embryos were implanted, resulting in eight live births.)
Thanks to better technology, though, single-embryo transplants are now almost as effective as multiple-embryo transplants – with far fewer health risks to both mom and baby. High-profile cases like Suleman’s have also raised awareness about the risk of implanting too many embryos.
“It’s something that will contribute to healthier pregnancies,” says Dr. Louis Weckstein, owner of the Reproductive Science Center, a fertility clinic operating in the San Francisco Bay area for 30 nearly years. “We educate patients that transferring one embryo in select situations is almost equally as successful as multiple transfers, and there are a number of studies largely confirming this.”