Elective single versus double embryo transfer

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c7083 (Published 22 December 2010) Cite this as: BMJ 2010;341:c7083
  1. Allan Templeton, professor of obstetrics and gynaecology
  1. 1Division of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK
  1. allan.templeton{at}abdn.ac.uk

Transfer of embryos one at a time is as effective and safer

This year, belatedly, Robert Edwards received the Nobel prize for his contribution to the development of human in vitro fertilisation. Louise Brown, the first child to be conceived after the technique was performed, was born in 1978. By the mid-1980s enough procedures were being performed around the world to get an idea of success rates, which became the early obsession. Around this time the main problem with the treatment also came to light—the increased incidence of high order multiple births. Twin birth is now the major problem, and in the linked study (doi:10.1136/bmj.c6945) McLernon and colleagues compared the effect of elective single embryo transfer versus double embryo transfer on pregnancy outcomes.1

Hank Morgan/Science Photo Library

In the beginning, clinicians transferred too many embryos, often as many as they had available. The initial data seemed to support this practice, with lower pregnancy rates when only one or two embryos were transferred compared with three or more. It was less well understood that the outcome was worse when only one or two embryos were available than when a pool of embryos was available, from which the better ones could be selected.2 Gradually, the …

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