Surrogacy Questions: How Many Embryos Should I Transfer?

Are you planning to have a baby with surrogacy but confused “How many embryos should I transfer per IVF cycle?” This is the question almost everyone asks. 

The answer is, the decision to transfer one or more embryos should be between the doctor, surrogate mother and intended parents. Usually, only one is transferred with a first attempt, especially if the egg is from a perfect egg donor or the intended mother is under 35 or if a Preimplantation Genetic Screening has been done. Women who have had full-term pregnancies before are more likely to carry multiple full terms (unlike a first-time mother).

This is the most precise answer I could give you. Read to the last to know more about the Embryo count, quality and other factors that can affect your pregnancy. Let’s Explore for a more detailed answer…

What Is an Embryo?

An embryo is the early developmental stage following fertilization up to the initial organogenesis. Following the zygote phase (during fertilization), the embryonic stage lasts until around the eighth week following fertilization.

Why Is It Needed?

In gestational surrogacy, an embryo is transferred to a woman who has consented to bear the pregnancy (surrogate) and give birth. The intended parents’ sperm, oocytes, or donor gametes may have been used to generate the Embryo. Altruistic and commercial surrogacy are the two categories under which surrogacy arrangements fall.

The Honest Answer Comes Here

According to the American Society for Reproductive Medicine, women up to 38 should typically transfer one healthy Embryo since “transferring a euploid embryo has the most favorable prognosis and should be limited to one in patients of any age.” As a result, many intended parents and surrogates will decide early in the legal contract phase that they will only be able to transfer one Embryo for each transfer procedure.

How Many Embryos Should I Transfer | Mysurrogatemom

Why Is Only One Embryo Advised?

To avoid having multiple births, women and couples frequently choose for a single embryo transfer. Carrying multiple babies at once raises the risk to the mother and unborn children, even if having multiple children may be desired.

Compared to singletons, twins are more likely to be delivered preterm and with lower birth weights. Triplets carry an elevated risk, which rises more with the number of offspring.

In a similar vein, the risk to the mother rises as the number of unborn children does. Along with additional difficulties, women who are carrying multiple kids are at an increased risk of developing gestational diabetes and preeclampsia.

Embryo Count vs. Quality

A woman’s ability to produce high-quality eggs decreases with age; this decrease usually begins at age 35. Women can become pregnant in their late 30s and early 40s without having to transfer many embryos at once if their eggs are harvested before the age of 35 and frozen for future use. This protects the quality of the eggs.

When two embryos are transferred, one of them is of lower quality than the other; it could fail in both embryos. According to a recent study, implanting two embryos of different quality resulted in fewer pregnancies than implanting one in about 25% of cases.

Unexpectedly, adding two subpar embryos did increase the likelihood of becoming pregnant. In what ways does this teach us? The body prefers quality and consistency over quantity.

Stages of IVF in Surrogacy

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Can You Have Twins with Two Embryos Per IVF Cycle?

While the chance of a twin pregnancy increases significantly, the chance of a single pregnancy does not rise significantly with the transfer of two embryos. Due to embryo “splitting,” a single embryo transfer could produce twins. After a single embryo transfer, the likelihood of identical twins developing naturally is 1.6%. (Twin pregnancies can occur from the splitting of the Embryo or from the release of many eggs during ovulation, which results in two unconnected pregnancies.) In the meanwhile, depending on the facility, the likelihood of a twin pregnancy after the transfer of two embryos might vary from 35% to 55%.

One Embryo at a time should be transferred if you wish to prevent a twin pregnancy.

Pros of Transferring Two Embryos

  • Raises your chances of pregnancy with associated risks
  • Saves time – get your baby faster
  • Reduce mother cost (Surrogate Mother Cost)
  • Can have twins, if you want

Don’t be intimidated by the pros. Always consult your surrogacy specialist before making any decision.

Cons of Transferring Two Embryos

  • Transferring two embryos increases the chance of multifetal pregnancies and associated complications.
  • There’s also a greater risk of having a deficient birth weight baby (weighing less than about 3 pounds).
  • The risk of preeclampsia (pregnancy-induced hypertension) in the woman carrying the pregnancy is about three times greater if she carries multiple.

Some Stats to Consider Before You Decide to Transfer the Embryos

  • Transferring two, you have around a 45% chance of having twins, 5% of triplets, and 1% quadruple.
  • The average birth weight is 2.5 Kg for twins and 1.7 Kg for triplets.
  • The average gestational age is 35 weeks for twins and 32 for triplets.
  • The percentage of pregnancies delivered before week 32: 12% for twins and 36% for triplets.
  • The percentage of babies needing NICU is 25% for twins and 75% for triplets.
  • The average time in NICU is 18 days for twins and 30 days for triplets.
  • 20% of triplets have a significant handicap.
  • The risk of death in the first year is increased seven times (with respect to a singleton) for twins and 20 times for triplets.
  • Twin pregnancies are more complicated on the surrogate, and triplets are more complex.
  • The risk of preeclampsia is 6% for twins and up to 12% for triplets.

Final Thoughts

A single healthy Embryo is the best option for the surrogate mother and the baby. Multiple Embryos mainly cause premature birth, which is harmful to the baby itself as premature babies lack cognitive abilities. The health of the surrogate mothers and the baby is essential.

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Written by David
I work daily to make surrogacy available to as many intended parents, surrogate mothers and egg donors around the world as possible.

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