Single vs. Double Embryo Transfer

Members of our wonderful team at Fertility Source Companies attended the Men Having Babies Surrogacy Conference in San Francisco in January 2016, and heard a wonderful presentation by high-risk OBGyn George Sylvestre, M.D. on single vs. double embryo transfer.

In the process of in vitro fertilization (IVF), the female ovaries are stimulated so that many eggs can be obtained. The reason for this is because most female eggs do not become viable embryos to be used in IVF thus increasing the chance that more embryos can be created from more eggs retrieved.

The discussion ultimately comes down to singleton or twin pregnancy. Many intended parents struggling with infertility, and many gay couples looking forward to their chance to be parents, want twins and are thrilled with the prospect of having two healthy babies in one cycle of IVF or surrogacy. The concern is for the twins to be healthy at birth.

In an article by our partner fertility practice The Fertility Center, it is described that twins are not always born healthy and that many risks are greatly increased with twin pregnancy:

“While any pregnancy has risks, many risks are greatly increased with twin birth. While singleton deliveries are associated with a 9% risk of low birthweight, a 2% risk of very low birthweight, and a 14% risk of prematurity, these same risks increase to 57%, 9%, and 65% with twin birth. With triplet birth, these risks are 96%, 34%, and 97%, respectively, according to a 2006 report by the Centers of Disease Control.”

Our agency is seeing more fertility physicians suggesting the practice of single embryo transfer in IVF and surrogacy cycles, as well as preimplantation genetic screening (PGS) to ensure healthy embryos. There is a significant increase of risk to the birth mother or surrogate mother with twin pregnancy and the cost is greatly increased as compared to a singleton pregnancy. It is estimated that the cost of a twin pregnancy is about fourfold that of a singleton. On the other hand, the success rates of pregnancy with two embryos is higher than single embryo transfer, which leaves many patients conflicted in their struggles to build a family. Many professionals and physicians in third party reproduction and fertility are educating patients about the increased risk and costs of twin pregnancy, so that intended parents can make an informed decision about whether to transfer one or two embryos.

It is our agency’s recommendation that intended parents discuss the overall implications of single vs. double embryo transfer with their fertility physician. When a surrogate mother is involved, it is also of the best interest of all parties to be on the same page and understand everything before entering an agreement. Please let us know if you need a physician referral, we have over 250 close partner physicians all over the country and would happy to help intended parents and surrogate mothers seeking additional information.