As some of you may have heard or read about, the ASRM (American Society for Reproductive Medicine) has recently issued new guidelines with regard to the number of embryos that should be transferred in fresh and frozen cycles. The new guidelines are as follows:
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For patients under the age of 35 who have a more favorable
prognosis, consideration should be given to transfering only a single embryo.
No more than two embryos (cleavage stage or blastocyst) should be transferred.
For patients between 35 and 37 years of age who have a more favorable
prognosis, no more than two cleavage-stage embryos should be transferred. All
others in this age group should have no more than three cleavage-stage embryos
transferred. If extended culture is performed, no more than two blastocysts
should be transferred to women in this age group.
For patients between 38 and 40 years of age who have a more favorable
prognosis, no more than three cleavage-stage embryos or two blastocysts should
be transferred. All others in this age group should have no more than four
cleavage-stage embryos or three blastocysts transferred.
For patients 41–42 years of age, no more than five cleavage-stage embryos or
three blastocyts should be transferred..
In each of the above age groups, for patients with two or more previous failed
fresh IVF cycles or a less favorable prognosis, one additional embryo may be
transferred according to individual circumstances. The patient must be
counseled regarding the risks of multifetal pregnancy. Both the counsel- ing
and the justification for exceeding the recommended limits must be documented
in the patient’s permanent medical record.
In women >43 years of age, there are insufficient data to recommend a limit
on the number of embryos to transfer.
In donor egg cycles, the age of the donor should be used to determine the
appropriate number of embryos to transfer.
In frozen embryo transfer cycles, the number of good-quality thawed embryos
transferred should not exceed the recommended limit on the number of fresh
embryos transferred for each age group.
We commend the ASRM for issuing these guidelines, and hope that clinics all over the country will adhere to them, without regard for statistics. At NHF, we have followed even stricter parameters since we opened our doors in 2004. Our focus is on producing few embryos of the highest quality, with the hope of reducing multiple pregnancies for women in all age categories.
Please read our post from October 12 with regard to reducing multiple pregnancies:
http://newhopefertility.typepad.com/my_weblog/2009/10/twin-pregnancies-and-how-to-avoid-them.html
As always, your comments and questions are welcome.
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