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Infertility

Transfer of 4 blastocysts

02/18/2009

Question:

We are a couple using a gestational surrogate,a young egg donor and my husband`s sperm due to my advanced age and infertiity. We achieved 9 frozen blastocysts from previous ivf cycle, which have been previously frozen. We were advised to transfer 4 blastocyst that survived a thaw into our surrogate. What are the chances 1, 2, 3 or 4 taking?

Answer:

You are correct to be concerned about the number of embryos that will be transferred. Multiple pregnancies have an increased risk of prematurity and resulting permanent disabilities. A greater number of fetuses is associated with an increased risk of prematurity. If you decide to transfer more than two embryos at one time, you should discuss selective reduction with your doctor in case three or more implant and develop successfully.

Before you agree to transfer any number of embryos greater than two, you should ask your IVF doctor what rate of multiple gestations he estimates the IVF program has for such transfers. Specifically, what is the average number of frozen donor embryos they transfer at one time, and what is their frozen donor embryo multiple pregnancy rate. Another way to get an idea would be to ask the doctor what is the average number of frozen embryos they transfer in women the same age as your donor (I assume she is less than 35), and their frozen embryo multiple pregnancy rate in this age group.

Once you know this information, you can balance the risk of multiple pregnancies with the risk of not getting pregnant and make an informed decision.

For more information:

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Response by:

William W Hurd, MD William W Hurd, MD
Professor of Reproductive Biology
School of Medicine
Case Western Reserve University