Why One Embryo at a Time Gives You the Best IVF Success

 
Patient: Dr Malpani, my friends told me that transferring two or even three embryos at once increases the chances of success. Should I ask you to transfer more embryos in my IVF cycle?

Dr Malpani: I understand why you feel that way. On the surface, it looks logical—more embryos, higher chances. But actually, it’s short-sighted and can reduce your overall chances of success.

Patient: Really? But if two embryos are transferred, isn’t the pregnancy rate for that cycle higher than transferring just one?

Dr Malpani: That’s true for that single cycle. But let’s look at the bigger picture. Imagine you have two good-quality blastocysts. If we transfer both at once and you don’t get pregnant, you’ll need to start a fresh cycle, which is costly and stressful.

Patient: And if I transfer one?

Dr Malpani: Then we can freeze the second embryo. If the first transfer fails, you still have another attempt ready—without needing another fresh cycle. And if the first transfer succeeds, you’ve saved an embryo for your second baby! That’s both cost-effective and emotionally less draining.

Patient: But what if both embryos implant? Wouldn’t that be a blessing—two babies at once?

Dr Malpani: It might sound like a bonus, but the risks are high. Multiple pregnancies come with increased chances of miscarriage, premature delivery, and complications that may land the babies in the NICU. Sadly, many of these babies struggle with lifelong health issues because they were born too early. And remember—this is an iatrogenic problem, caused by transferring too many embryos.

Patient:I didn’t realise that. So, transferring one embryo at a time is actually safer?

Dr Malpani: Exactly. With vitrification, embryo freezing is almost 100% successful in good labs. Plus, frozen embryo transfers often have higher implantation rates because we can prepare your endometrium optimally. So, transferring one embryo at a time not only reduces risks but also increases your cumulative chances of success.

Patient: That makes sense. But what if a doctor insists on transferring multiple embryos?

Dr Malpani: That’s a red flag. It usually means the doctor isn’t confident about the quality of the embryos their lab produces. The best safeguard for you is to always ask for photographs of your embryos—this is standard practice in good clinics worldwide.

Patient: Thank you, Dr Malpani. I feel much clearer now. So, in IVF, more is not always better.

Dr Malpani: Exactly! The safest, smartest strategy is one embryo at a time.

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