It’s an important conversation that every prospective surrogate and intended parent should have with their medical professional: How many embryos should I be comfortable with in a single transfer?

Ideally, this conversation should take place well before an embryo transfer — even before someone starts the surrogacy process at all. However, new research from FertilityIQ estimates that 1/5 of all patients undergoing infertility treatments are only educated about the facts of a multi-embryo transfer immediately before the procedure itself.

Clearly, both intended parents and surrogates need to advocate for themselves while preparing for this step of the surrogacy process.

At American Surrogacy, our specialists will help connect you with an appropriate medical professional early on in the process. This way, you can learn about the pros and cons of transferring multiple embryos to make the best decision for you.

Rather than solely relying on one doctor’s recommendation, it’s important that intended parents and surrogates do their own research to learn about this topic from several resources. To help you start that process, we’ve listed some of the basic information you need to know in this article.

The Basics and Risks of the Transfer Process

In every in vitro fertilization process, intended parents will need to decide how many embryos they want to transfer to the mother’s (or surrogate’s) uterus. Usually, this decision will be influenced by several factors, like:

• The health of the mother or surrogate
• The results from pre-implantation genetic screening
• The intended parents’ budget and wishes

A fertility doctor should speak at length with intended parents about this decision, as it’s one that has many different repercussions for all involved. Unfortunately, not all doctors take this approach — instead recommending one path over another, after which intended parents often go with the suggested embryo transfer number.

While each medical situation is unique, it’s important to note that transferring more than one embryo comes with well-documented risks. Carrying multiples increases medical complications for both mothers and children by almost five times. These medical complications, like early birth, can cost parents more money and cause more emotional distress than a single birth resulting from a single-embryo transfer.

Still, doctors may recommend multiple embryo transfers in older women to increase their chances of pregnancy, despite these risks. No matter what the situation, all intended parents should be fully educated about both options long before the transfer takes place.

So, Which is Better: A Single- or Multiple-Embryo Transfer?

It would appear that single-embryo transfer is the safer path to take, right? It may be, but many American intended parents today aren’t following this path.

As a whole, intended parents in the U.S. complete far more multiple-embryo transfers compared to single-embryo transfers than other countries — in fact, more than twice as often as intended parents in Australia, based on FertilityIQ’s research. This is due to several factors.

In the U.S., the cost of an IVF process is much more expensive than the cost of those in countries where the healthcare system is paid for or greatly subsidized by the government. Therefore, intended parents often transfer more than one embryo their first time to reduce the chance that they need to pay for more than one transfer process.

Research also shows that there is no consistent education offered to intended parents among fertility clinics. The amount and accuracy of information will vary based on the doctor being used — which could be a possible reason why so many intended parents choose to do a multiple-embryo transfer early in the process.

The discussion about how many embryos to transfer in the surrogacy process is an even more complicated one. After all, the risks of a multiple-embryo transfer will not be carried by the intended parents but by the surrogate — which should impact the intended parents’ desire to transfer multiple embryos in the first place.

The American Society for Reproductive Medicine usually only advises one healthy embryo be transferred in women up to age 38, because “in patients of any age, transfer of a euploid embryo has the most favorable prognosis and should be limited to one.” Therefore, many surrogates and intended parents will determine during their legal contract phase that their embryo transfer will be limited to one for each transfer process. If it is decided that multiple embryos will be transferred, the contract should also address the financial protections for the possibility of carrying multiples and any subsequent complications.

If intended parents or a surrogate are considering a multiple-embryo transfer during surrogacy, we recommend you speak in detail with your surrogacy specialist and your fertility doctor for more information about the risks and benefits of doing so. The surrogacy specialists at American Surrogacy are always available to discuss your personal surrogacy situation if you call them at 1-800-875-2229(BABY) today.