HOW MANY EGGS ARE ENOUGH?

How many fertilized eggs should be transferred in a single IVF procedure? Some couples press for two, believing it doubles the chance of pregnancy and that getting two babies in one cycle would be ideal.

“It’s our duty to explain, sensitively and carefully, that more embryos do not necessarily improve their chances,” Dr. Victor Akinsooto says. “It may increase the pregnancy rate, but not live births.”

Risks in twin or triplet pregnancies include premature birth and cerebral palsy in infants and higher incidence of gestational diabetes and pre-eclampsia in the mother.

Efforts to lower the rate of IVF-assisted multiple pregnancies began in Canada after 2006, when North American IVF clinics reported the highest rate of multiple pregnancy among all 21 countries surveyed.

In 2009, medical directors of all 29 clinics in Canada voted unanimously to work toward reducing the multiple pregnancy rate to 15 per cent by 2015. Should two or more embryos be available, transfer of one while freezing the others for transfer later was recommended.

In 2010, to reduce the high cost of medical care before and after multiple births, Quebec became the only province to pay for up to three IVF cycles with the stipulation that only one embryo could be transferred per cycle unless a physician decided otherwise. In a year, Quebec’s multiple pregnancy rate fell to 5.2 per cent from 27.2 per cent.

“A clinic willing to transfer multiple embryos will achieve a high pregnancy rate, but it comes at a cost,” Dr. Roger Stronell says. “The goal has to be to get women pregnant safely and see them take home a healthy baby.”