Two Embryos Increase Chance Of IVF Success, Say Fertility Experts

Two Embryos Better Than One Say Experts

The Huffington Post UK   First Posted: 12/01/12 13:34 GMT Updated: 12/01/12 16:42 GMT

Fertility experts are appealing for a U-turn in the current rules against multiple embryo IVF implantations, after a new study has revealed that two embryos are better than one – especially for older women trying to conceive.

According to researchers from the Medical Research Council in Bristol and the University of Glasgow, two embryos are better than a single embryo when increasing the chances of a successful pregnancy and live birth, despite previous claims that multiple embryos increase the risk of pregnancy and birth implications.

A spokesperson from the study said: “Greater freedom should be given to clinicians and patients to decide whether to transfer one or two embryos, according to prognostic indicators, such as maternal age.”

The previous belief that the more embryos implanted, the better the chances of conception, resulted in a boost of multiple IVF babies, with 24% of IVF pregnancies resulting in twins or triplets in 2008. Fertility experts became concerned with this statistic, as multiple pregnancies and births as a result of IVF are the single biggest health risk to both mother and child, carrying high risks of premature birth, miscarriage and pre-eclampsia.

As a result, in 2008, the Human Fertilisation and Embryology Authority (HFEA) ordered IVF clinics to reduce the number of multiple births from 24% to 15% by restricting the number of embryos down to one per cycle. The new guidelines paid off, as multiple birth rates lowered to 18% while live birth rates are steadily rising.

However, the new study, published in The Lancet, is appealing for legislations to be relaxed by giving would-be-mothers “greater freedom” when deciding on whether to transform one or two embryos. They came to this conclusion after analysing the outcomes of 124,148 IVF cycles resulting in 33,514 live births.

This is particularly encouraging for older women trying to conceive as it’s been proven that two embryos are more successful in women over the age of 40, as they carry less health risks than in younger women.

"Our findings provide some support for the transfer of two embryos in women older than 40 years, because the risks of pre-term and low birth weight were lower than those in younger women," says a spokesperson from the study.

Meanwhile, the HFEA have spoken out defending their decision to restrict multiple embryos, saying that they didn’t ‘ban’ clinics from doing so, but asked them to select double embryo patients carefully. The full guidelines can be seen on the British Fertility Society’s website.

Medical Director, Dr George Ndukwe, from the Zita West Clinic, added: "Female age is the most important determinant of successful live birth after IVF. Pregnancy rates decline steadily over the age of 35 to less than 5% in women in their 40s.

"I welcome this study because it confirms what we already know – that transferral of two embryos improves chances of success for older women. There’s no justification for the HFEA or any other body to limit the number of embryos transferred in women over 40 to a single embryo in light of this study. Most practitioners are very responsible and should have greater freedom to use their clinical judgement in making decisions in treating their patients," he told The Huffington Post.

However, not all fertility health experts agree that the double embryo appeal will make a drastic difference to older women conceiving via IVF.

“I am an advocate of single embryo transfer because I believe it results in pregnancies that are much lower risk,” fertility expert Emma Cannon told The Huffington Post.

“However, there are always exceptions to the rule and there will be occasions in older women where transferring two embryos is acceptable. But there needs to be special circumstances and I do not believe age is the only indicator. Some women in their 40's perform extremely well and produce good amounts of eggs I see no reason why these women need transfer more than one embryo.

“Other women produce very few of low quality in which case the clinical decision maybe taken to transfer two as the risks of multiple pregnancy would be deemed small. It's important to remember that embryos can always split and one embryo can still become two and two embryos can still become three or even potentially (I have never seen this) four.”

Although the transferal of two embryos is heavily supported in this study, researchers added that three embryos should never be attempted as it massively increases the risk of premature birth. It is currently illegal for a woman over 40 to have more than three embryos into the uterus and over two for women under 40.

Rachel Cutting, Chair of the Association of Clinical Embryologists (ACE) also told The Huffington Post:

"Ensuring the health of both the mother and her baby is our priority and as a result ACE supports the use of single embryo transfer in those patients who are most likely to have multiple births, which is usually those under 37 years old who have good quality embryos.

"That said, it should remain flexible for patients who are less likely to have a multiple birth. It may be suitable to transfer two embryos into patients over 40 years old so as not to compromise their chances of falling pregnant. But any woman having more than one embryo replaced must be fully aware of the health risks involved in a multiple pregnancy.

"We also understand the financial burden for some women of paying for IVF and are calling for more NHS funding for IVF Treatment as we feel that women would be more likely to agree to single embryo transfer if they were able to undergo their treatment on the NHS. It makes financial sense for the NHS to do this because the cost of care for multiple births is far higher than the cost of a cycle of IVF," she explained.

Further to this, the study’s results come after the NHS revealed that it plans to sharply cut funding of IVF cycles, as reported by GP’s magazine, Pulse. The average number of cycles funded each month by primary care trusts so far in 2011/2012 is 14% behind the average rate for the whole of last year, based on Freedom of Information responses collected from 29 trusts.

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Fertility experts are appealing for a U-turn in the current rules against multiple embryo IVF implantations, after a new study has revealed that two embryos are better than one – especially for olde...
Fertility experts are appealing for a U-turn in the current rules against multiple embryo IVF implantations, after a new study has revealed that two embryos are better than one – especially for olde...
 
 
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HUFFPOST SUPER USER
WilmaJune
12:37 AM on 01/13/2012
This is sick. Naturally, fertility experts will push their agenda. Older women keep kidding themselves into believing how young and vibrant they are. My children were born ten years apart. I did not begin to have the energy with the second one that I had with the first and I was under 35. The question is, why do you want a child? Go to a shelter and bring home a pet. Don't want to take care of a pet? Then, you have no business having a baby. Why? Babies are more demanding and live much longer than pets.
10:30 PM on 03/29/2013
not all IVF patients are over 40. I'm 27 and cannot conceive naturally due to a medical condition and why shouldn't I be allowed to have the same opportunity that you have with your two children? A pet can only fill the void left in your life by infertility for a while. I draw the line at 1 dog 2 cats 1 ferret 1 chinchilla 2 axolotl and a horse because they become pseudo children and that's not fair on the (i'm a vet nurse so I see it often). You will never understand the longing because you will never feel it, not a man but not quite a woman, mutant, barren etc. the constant worrying hubby will leave because he wants and deserves a family, friends calling and instead of sharing fantastic news they say "i'm sorry, I'm pregnant". The inability to even go shopping for fear of breaking down whilst passing the maternity section and the understanding of how someone could actually snatch a child - not condoning it but understanding it. people with the parenting skills of your average root vegetable being able to breed and everyone else pays taxes to provide for them and knowing the child would be better off but it wouldn't help because inside your still barely human. the only way you would ever understand how this feels is if someone took your children and you never heard from then again so please don't judge others until you have walked in their shoes.
HUFFPOST SUPER USER
WilmaJune
07:21 PM on 03/30/2013
My husband left because he did not want to be a father.  Personally, I never gave much thought to whether or not I wanted a child.  For me, childbirth ended a marriage.  In my opinion, parenthood is over-rated.  I never pretended to understand those who drive themselves crazy trying to conceive. 
10:52 PM on 01/12/2012
Women over 40 are too set in their ways and selfish. They have had their cake and now they want to eat it. It have always thought it a downright disgrace that the only person taken into consideration is the old childish woman and not the child. It should be taught that children need a lot of dedication, time, sacrifice and energy. Scientists should spend their money on researching stuff that benefits mankind. There are so many unwanted babies and children on this planet that need love and attention and someone to give them a good start in life without creating more children. I think it is another vanity thing in older women something else to make them feel "young again". It will all end up in tears as has other "cosmetic" enhancements.
10:13 PM on 01/12/2012
We have too many people on this planet, why try to make more?
08:58 PM on 01/12/2012
Huff, why do you stop the response posts on the abortion issue? At least those you are not in favor of?
08:58 PM on 01/12/2012
Huff, why do you close off debate on abortion posts?