Wednesday, July 01, 2015

Multiple Reasons Why Multiple Embryos Shouldn’t be Transferred in IVF



A large number of clinics in India, very routinely transfer 4-5 embryos during the IVF treatment. This, even in the case of young patients who are doing their first IVF cycle. This is a very worrisome trend because transferring multiple embryos also significantly heightens the risk of multiple pregnancies.

The Concern

The different reasons why this is a major concern:

Many patients will end up having triplets, who have a very high risk of ending up in the NICU because of prematurity.  These  babies may end up having lifelong disabilities because of their preterm birth
Others will end up miscarrying after a selective fetal reduction

While the patients are happy that the IVF treatment has been successful, that the long wait is finally over and they will now get to be parents, this happiness could be tainted by one of the issues mentioned above.

In Contrast

Contrastingly, the IVF doctor is jubilant and then proudly counts that pregnancy as a success; while in reality, the entire scenario has been a fiasco and a disaster for the patient. If you are wondering why I say this- it’s simple, it isn’t the doctor who has to provide the required pregnancy care or even look after fragile preterm babies. This means, he rests on his laurels while his patients bear the brunt of his actions.

Sign of a Bad Clinic

The fact that the clinic willingly transfers so many embryos is actually a sign that this is not a good clinic! They are compelled to transfer multiple embryos because they don’t have enough confidence in their lab. There is no other way in which they can inflate success rates. A good clinic is able to create good quality embryos that have a high implantation rate.

Adding fuel to the fire are the patients who pressurize doctors to transfer a larger number of embryos. In doing this, they are being myopic with their choices and the only aspect they are looking at is- It increases their chances of having a baby. Most are at the end of the tether and just feel that just about anything would be better than not having a baby at all. They don’t realize that in effect, they are jumping from the frying pan into the fire.

Things to Keep In Mind

Keep in mind that transferring more embryos does not increase success rates; it only increases the risk of a multiple pregnancy; and in IVF, more is not always better!
A good clinic will generally transfer only one embryo (if it's a top-quality blastocyst)
For selected patients (older patients/those who have failed many IVF cycles), they may be justified in transferring more embryos, but not otherwise
A clinic that routinely transfers an excessive number of embryos is a bad clinic because they are not confident about their embryo implantation rates
In a good clinic, 50% of the top quality blastocysts will implant successfully. This means their implantation rate is 50%
The reason the other blastocysts do not implant is because they have an unidentifiable lethal genetic problem; this causes them to stop growing and prevents them from implanting
This is why we still cannot predict which blastocyst will become a baby
This is also why transferring three blastocysts would give an extremely high success rate; but  it would also result in a very high number of multiple pregnancies

What a Good Clinic Does

A good clinic that has high pregnancy rates because it creates top quality embryos with a high implantation rate, will discourage patients from transferring too many embryos; they are confident they will have a high pregnancy rate even after transferring just 1 or 2 embryos. What’s even better is that the spare embryos are not wasted. The supernumerary embryos can be cryopreserved safely, and used later on to complete your family!

Worried that your IVF doctor wants to transfer too many embryos and that he is taking the risk of a multiple pregnancy too lightly? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better!



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