Exploring the risks of double embryo transfer and the alternative option of SET

If you’re struggling to conceive or you’ve lost a pregnancy or a baby, you might be surprised when your fertility doctor suggests that you do a single embryo transfer (SET). After all, wouldn’t transferring two or more embryos increase your chance of success? It turns out that more isn’t always better. At The Fertility Center of Las Vegas, in 99% of cases, our doctors only transfer one embryo at a time. This is because there are several risks associated with transferring more. Here, our Las Vegas fertility center team explains some of the risks of double embryo transfer (DET) and the benefits of SET.

Does IVF increase the risk of having a pregnancy with multiples?

Many people think that in vitro fertilization (IVF) comes with a higher risk of having a pregnancy with twins, triplets or even higher order multiples. However, it’s possible to significantly reduce the risk of having a pregnancy with multiples by controlling how many embryos are transferred. For example, a detailed analysis of fertility treatment outcomes revealed the following statistics.

There was a 1% chance of having twins and a 0.2% chance of having a pregnancy with triplets or higher multiples when fertility doctors transferred just one embryo (SET).
When transferring two embryos, the odds of having twins was 38% and having triplets or higher order multiples was 1%.

Clearly, transferring more than one embryo increases the likelihood that a patient will have a pregnancy with multiples.

What are the risks of double embryo transfer?

When patients first visit our Las Vegas fertility center, they often don’t understand why having twins or triplets is a problem. Some patients may even say that they want to have twins. However, having a pregnancy with multiples is more difficult for the woman carrying the pregnancy, and it also poses several risks to the babies. Here are some of the most common risks of double embryo transfer.

The risk of having a low birth weight baby (weighing less than 5.5 pounds) increases from 9% when a woman carries just one baby to 57% with twins and 96% with triplets or higher order multiples.
There’s also a greater risk of having a very low birth weight baby (weighing less than about 3 pounds). The risk is about 9% when a woman is carrying twins and about 34% if she is expecting triplets or higher order multiples, compared to a 2% risk in singleton pregnancy.
Preterm birth (being born before 37 weeks) is also more common in twins (65%) and triplets and higher order multiples (97%) compared to a 14% risk in a pregnancy with just one baby.
The risk of pre-eclampsia (pregnancy-induced hypertension) in the woman carrying the pregnancy is about three times greater if she carries multiples.

These issues are associated with several additional risks. For example, preterm birth is associated with prolonged hospitalization, intellectual disability, low birth weight, cerebral palsy, other serious health problems and even infant death. This results in much higher healthcare costs and much more stress for the parents.

What if a fertility doctor transfers more than one embryo, but only one develops into a baby? It turns out this can still increase the risk of the baby being born prematurely and/or having a low or very low birth weight.

What if a patient still wants to transfer two embryos?

Many patients think that transferring two embryos guarantees that they will have twins, which can be especially appealing after experiencing infertility or pregnancy loss. However, a DET doesn’t give patients “more for their money.” In fact, it can lead to higher costs in addition to significantly greater health risks.

A pregnancy with multiples can also lead to additional financial and emotional costs if the babies (or the woman carrying the pregnancy) experience health issues. These costs can include additional pregnancy monitoring, possible bedrest, longer hospital stays, time in the NICU and long-term medical care after delivery. Also, if you’re using a surrogate and she conceives multiples, you’ll have to pay more in surrogate compensation and insurance, assuming that the insurance company will even cover a multiple pregnancy and delivery. This doesn’t even consider the added non-medical costs, including having to purchase a larger home and car. Opting for a single embryo transfer is a simple way to avoid many of these issues.

What are the benefits of SET?

It can be startling to learn about the risks of double embryo transfer, but thankfully, a single embryo transfer can significantly reduce them. Having a safe pregnancy and a healthy baby are two of the key benefits of SET.

If single embryo transfer is so beneficial, then why don’t all fertility clinics do it? Transferring multiple embryos at the same time can help artificially inflate IVF and live birth rates as a way to compensate for low implantation rates. Our Las Vegas fertility center uses the latest methods to improve IVF implantation rates, including blastocyst transfer, preimplantation genetic testing and frozen embryo transfer. This allows our team to increase the odds of having a successful pregnancy after transferring just one embryo.

Want more information about the risks of double embryo transfer and benefits of SET? Contact us to schedule an appointment and learn more.