Using one embryo in IVF doesn’t cut birth rate: study

Transferring one embryo into women during in vitro fertilization (IVF) doesn’t lower their chances of giving birth but it does mean fewer women give birth to twins, with all the attendant health risks, a study said.

IVF has traditionally involved transferring multiple embryos, which is known to increase by many times a woman’s chances of having twins and other multiple births, and raise risks to both mother and babies, including diabetes during pregnancy, premature birth and cerebral palsy.

But improved technology has helped increase births if single embryos are used in younger women judged to have a good chance of getting pregnant, said Jessica Kresowik at the University of Iowa in Iowa City, who led the study.

“In the past, you did need to implant multiple embryos in order to maintain those pregnancy rates,” Kresowik told Reuters Health of the study, published in the journal Fertility and Sterility.

She added that before technology improved, doctors might use six embryos at once, hoping that one would result in a pregnancy. According to the American Society for Reproductive Medicine, no more than two embryos should be transferred for women under 35.

What is IVF?

IVF is an acronym for in vitro fertilization (‘in vitro’ meaning ‘in glass’). Simply put IVF is adding a man’s sperm to his female partners eggs in the laboratory to produce embryos. In vitro fertilization is an option for many couples who cannot conceive through conventional therapies. These embryos are put back into the female partner’s uterus (womb) after 3 to 5 days of being in the incubator, hopefully they will then grow into a baby. The reasons IVF is done include - poor sperm quality and/or quantity, obstructions between the egg and sperm, ovulation problems, and sperm-egg interaction problems. These problems can prevent couples having a baby naturally, and IVF helps to solve this.

Specific conditions that might require IVF include:

  * Tubal blockage or failed tubal reversal
  * Endometriosis
  * Cervical factor
  * Pelvic adhesions
  * Male factor
  * Unexplained infertility/ failed conventional therapy
  * Genetic testing (PGD) for inheritable diseases
  * Genetic testing (PGD) for possible reasons for multiple miscarriages

The first IVF baby was Louise Brown, born at 11:47 p.m. on July 25, 1978 at Oldham General Hospital, Oldham, England through a planned caesarean section. She weighed 5 pounds, 12 ounces (2.608 kg) at birth. Dr. Patrick Steptoe, a gynecologist at Oldham General Hospital, and Dr. Robert Edwards, a physiologist at Cambridge University, had been actively working on finding an alternative solution for conception since 1966.

Babies conceived through IVF account for just one percent of births each year, but IVF is responsible for 17 percent of twins, Kresowik added.

Using a single embryo for IVF for all women under 38 who were getting their first round of IVF and had other signs predicting a good outcome became policy at Kresowik’s fertility clinic in 2004.

Data for the five years before and after that time showed that birth rates didn’t suffer - and actually improved.

Before the single embryo policy, 51 percent of all women younger than 38 got pregnant and gave birth to a live baby, compared with 56 percent afterwards.

The proportion of women with multiple births dropped from 35 percent to less than 18 percent.

Among 364 women who fit the criteria and had a single-embryo transfer from 2004 on, 65 percent gave birth to a live baby and just over 3 percent had twins or other multiple births.

“A policy like this is a great idea,” said Judy Stern, a fertility specialist at the Dartmouth-Hitchcock Medical Center in New Hampshire, who wasn’t involved in the study.

“You really can move toward single-embryo transfer and have it give you great success rates, and really low multiple rates,” she told Reuters Health.


Provided by ArmMed Media