The recent news of the birth of octuplets has brought the debate about embryo transfer back into the spotlight. Higher order multiples usually result from IVF treatments involving the transfer of many embryos. In most cases, all transferred embryos don’t implant. However, in some cases all do implant successfully, resulting in a higher order multiple pregnancy.
Infertility clinics vary widely in the United States regarding the number of embryos transferred during one IVF cycle. The logic behind implanting a larger number of embryos is to improve the success rates for the clinic. Since many embryos will not successfully implant, there is a higher chance a woman will not conceive with only one or two embryos implanted than with four or more. Many reproductive endocrinologists don’t consider this practice to be ethical.
Many clinics have limits on the number of embryos to three. This is done because multiple pregnancies are inherently high risk and the risk increases with the number of babies. Other clinics implant on the fifth day to ensure the healthiest embryos are chosen, so fewer can be implanted while still offering a better chance of success.
A large part of the controversy surrounding embryo transfer is tied into the abortion debate. This is due to the need, in some cases, for a procedure known as selective reduction. When a large number of embryos is successfully implanted, the procedure is sometimes done to reduce the number of babies in an attempt to save the pregnancy and prevent the myriad of health problems associated with higher order multiple births.
These health problems can be significant with life long repercussions. The cost in terms of medical, therapeutic and special education programs is high, as is the stress caused to families and marriages. This is a big reason many doctors limit the number of embryos transferred in one IVF cycle.
Some countries are moving toward regulations with strict limits on embryo transfer. The Human Fertilisation and Embryology Authority is the regulating body of infertility treatments in the United Kingdom. This organization is considering a regulation which would allow only one embryo to be transferred during one cycle. Several other European countries already have this regulation in place.
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