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The decision to perform an in vitro fertilization (IVF) or an ICSI is usually accompanied by a very common doubt … What chance do I have of having a multiple birth with this technique? …

This is because of the number of embryos transferred, in an attempt to increase the chances of achieving pregnancy. In many cases it is advisable to transfer a single embryo and vitrify the rest, but many couples due to the psychological, physical and economic effort, prefer to expose themselves to a possible multiple pregnancy, to increase their probabilities.

Of course, each couple and each patient have different circumstances and therefore needs, that is why the team of HC Fertility – The Center of Fertility in Marbella, is involved to help make the best decision in each case, but the couple always make the final decision.

One of the embryologists of HC Fertility, Maria Jose Figueroa, solves the most common doubts about embryo transfer.

Who is the person making the decision on the number of embryos transferred in an IVF treatment?

We began by clarifying that although the Law in Spain allows us to transfer up to 3 embryos; in HC Fertility we never transfer more than 2 embryos.

The last decision on the number of embryos to be transferred the couple has, except when the doctor considers that there is a high risk for the woman to carry a possible twin pregnancy and in that case the doctor will decide that no more than one embryo is transferred.

Embryo transfer can be done on different days of embryo development, in synchronization with the endometrial cavity. When transferring embryos on day 3 of development, this is three days after the egg collection, the tendency is to transfer 2 embryos and when we transfer on day 5 of development, (blastocyst) we advise to transfer a single blastocyst, but always with an agreement between the team and the couple.

Is there a limitation by law in Spain that controls the number of embryos to be transferred?

As we have said before, the Law in Spain allows us to transfer up to 3 embryos.

What risks exist in the transfer of several embryos?

The greatest risk of transferring 2 embryos is a twin pregnancy, with the consequences of this type of pregnancy.

What is the average number of embryos transferred per year in IVF treatments?

According to the last National Register of Activity 2014-Registro SEF published, these are the means according to the different options that exist

In fresh cycle with own oocytes, the average of embryos transferred was: 1.8

-The percentage of cycles with Transfer of 1 embryo: 25.4%

-The percentage of cycles with Transfer of 2 embryos: 68.2%

-The percentage of cycles with Transfer of 3 embryos: 6.4%

In crio transfer with oocytes of the same type, the average number of embryos transferred was: 1.7

-The percentage of cycles with Transfer of 1 embryo: 37.6%

-The percentage of cycles with Transfer of 2 embryos: 57.5%

-The percentage of cycles with Transfer of 3 embryos: 4.9%

In the fresh cycle with donated oocytes, the average embryos transferred were: 1.8

-The percentage of cycles with transfer of 1 embryo: 23.7%

-The percentage of cycles with Transfer of 2 embryos: 73.2%

-The percentage of cycles with Transfer of 3 embryos: 3.2%

In crio transfer with donated oocytes, the average embryo transferred was: 1.7

-The percentage of cycles with Transfer of 1 embryo: 38.7%

-The percentage of cycles with Transfer of 2 embryos: 55.7%

-The percentage of cycles with Transfer of 3 embryos: 5.6%

According to the reports offered by the Spanish Society of Fertility, the tendency on the number of embryos to be transferred is to transfer an embryo at the blastocyst stage.

At HC Fertility we analyze each case and personalize the protocol, studying all the possibilities and valuing all the options to get the best results for that family and of course for the patient

Maria José Figueroa

Embryologist at HC Fertility – Fertility Center in Marbella

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