Do single embryo transfers lead to increased pregnancy rates?

 One of the most frequent questions I have from patients is: If we only have one embryo on day three, and it doesn't even appear to be an embryo of very high quality, should we just transfer it, or should we ask the doctor to grow it until day five and then perform a blastocyst transfer? After all, isn't a bird in the hand too in the bush because if we put it back in the uterus it may implant who knows? However, if it remains in the lab, no transfer will take place, and there won't be any chance for implantation so we're guaranteeing that our chances of success are zero. 

This is the excuse used by many IVF clinics to delay embryos after day three, although in truth if the lab is a good one, the embryo will rest there anyway. It will also rest in the uterus, so you have unnecessarily put yourself through a trying two-week waiting period filled with false hope. Why would you want to do that? Wouldn't it be better to know that the embryo rested instead of having to wait for those terrible two weeks when every little twinge could mean you're pregnant or not? In addition, you lose that crucial information because, if the cycle fails, you'll not even know why, whereas if you let the embryo arrest in vitro, you'll know the issue was with the embryo and can fix it in the next cycle. Please don't let your doctor do this; it might be in his best interests, not yours. The whole idea is that by returning embryos to day three, you're losing crucial information

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