The more embryos replaced the greater the chance of pregnancy but there is also an increased chance of multiple pregnancy. Multiple pregnancy results in increased complications of pregnancy for mother and baby including premature delivery and perinatal mortality (loss of a baby before delivery or in the first week after delivery.0001,0201,0602 Whereas one pregnancy in a hundred will have been conceived by assisted conception in the UK and other developed countries, it has been estimated that 50% of babies requiring care in a special care baby unit are IVF babies.

Successful outcome with IVF has increased as techniques have been refined. On 3rd August 2001,

The Human and Embryology Authority, which administers IVF clinics in the UK, decided to reduce the number of embryos that can normally be transferred from three to two. The multiple pregnancy rate for IVF in Europe still approaches one in four.0601  

In women younger than 36 years, single embryo transfer followed by transfer of another single frozen embryo when initial treatment has failed results in similar livebirth rates but with lower incidence of multiple pregnancy.0402The cost effectiveness of repeated cycles of elective single embryo transfer may be better than double embryo transfer because of the savings from reduced twin pregnancies.9801

Careful consideration now needs to be made of the case for transferring just one embryo. The case for elective single is contested is contested.0604 It is likely that single embryo transfer will replace double embryo transfer when there would be a high chance of multiple pregnancy.0401,0501,0701

The elective single embryo transfer policy can still be applied reducing the risk of multiple birth and increasing the safety of assisted reproduction technique (ART) in this age group. 0603

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