Embryo transfers in IVF: more need not always be better
Health minister Leoš Heger has announced that within a broad reform of the health system he wants to change the rules for fertility treatment. The minister has proposed curtailing the practice of multiple-embryo transfers in assisted pregnancies – in favour of single-embryo transfers on the grounds that it is the most inexpensive IVF method and least likely to result in high-risk multiple births.
“If we plan an embryo-transfer it is a three-party agreement – based on the couple’s request, the advice of the gynecologist and that of the embryologist. So it depends on the quality of the embryos – that is one of the most important factors and then the willingness of the couple to try for a single baby rather than twins. Some couples aim for twins and we try to discourage them from that plan. “
“Yes, some couples specifically wish to have twins, so we have to explain what the drawbacks are.”
Does a multiple-embryo transfer not also increase the chance of conceiving?
“Of course, that is why it is a three-party decision where we must try to weigh all the factors and find the best way to achieve pregnancy. But we must point out that having twins or even triplets (triplets are a disaster) involves certain risks and is not very good. So we have a rule about never using three embryos in the first IVF cycles. I think that in about 50 percent of cases we undertake a double embryo-transfer. The rest are single embryo-transfers.”
How would your patients –who are often desperate to conceive -react to a change of the law – would they see it as discriminatory?
“No, I think most women would see the decision as a chance to have longer infertility treatment covered by health insurance. I do not think it would be viewed as discrimination. Single-embryo transfers are becoming a standard practice in many countries of the world and I think that will soon be the case of the Czech Republic.”