IVF and Embryo Therapy
What is the reason for placing more than one embryo in the uterus when the IVF method is applied?
Multiple embryos in the uterus only reason for placement pregnancy to increase the chances.
This procedure to increase the chance of pregnancy increases the likelihood of multiple pregnancy in IVF treatment tedWhen we look at the statistics, we see clearly that, for example, when a single embryo is transferred to women under the age of 35, which is the best category, that woman has a 20 percent chance of becoming pregnant. When two embryos are transferred, this figure is almost doubled and approaches 40 percent. If it is transferred, it reaches a figure of 50-60 percent. The interesting thing is that the chances of pregnancy increase after four. In this case, the risk of multiple pregnancy increases. When two embryos are transferred and become pregnant, 70 percent are singular and 30 percent twin. When three embryos are transferred, approximately 60 percent are singular, 30 percent twins, and 10 percent triplets.
In Europe, the state imposes certain limitations on how many embryos will be transferred, as the entire cost of the IVF is covered, and multiple pregnancies have a substantial financial and moral burden on society. In countries such as Germany, Italy, women younger than 35 years of age require only one embryo transfer in the first in vitro fertilization trial, and when calculated, single embryo transfer plus freezing of the remaining embryos and then transferring the frozen embryos one by one, in fact, transfer the two or three embryos at once. almost the same figures. However, there is a need to achieve as high success as possible with as few attempts as the cost of IVF is quite high in the USA and especially in our country and many couples have to pay it out of their pockets.
For this reason, 2 or 3 embryos are usually placed in our country even if the woman is younger than 35 years. If the embryo quality is good, it can be reduced to 2, 2 embryo transfers are sufficient for women younger than 35 years of age.
In this video you can find out what you wonder about multiple pregnancy in IVF:
Is it necessary to insert more than one embryo?
Necessity depends on need.
Placing multiple embryos is not necessary to have pregnancy. But it is necessary to achieve high pregnancy rates.
Obviously, in a society where there are no financial problems, the ideal is to transfer a single embryo and to repeat it if there is no pregnancy. Either as a transfer of frozen embryos or by attempting a new treatment cycle. However, it can be sympathetic for many people in our society to be twins.However, even twins have very important problems both during and after pregnancy. The most important of these is premature birth. Many twins have a risk of preterm birth and there are many physical difficulties both in infants and in the mother, which would result from preterm birth.
Premature infants may have many problems, including respiratory failure, but the skull is fully developed, from birth to bleeding in the brain, and consequently neurological disorders.
But nowadays, maturation of twins can be achieved with a good birth follow-up. That's why the twins are out of the high-risk group. But any multiple pregnancy above the twin falls into a very high risk category and I do not recommend.
How many embryos can be placed in the uterus?
It depends a little on the attitude of that IVF center. But I always leave the final decision to the family. After explaining the plus, the minus, the risks, and with a certain limitation, I leave the final decision to the family. I ask the family to choose between two or three embryos. But if the family absolutely wants four embryos to be transferred, I would disagree as a doctor and refuse to do so. However, on the other hand, I tell the family that the chance of success is reduced even if they only want one.
How many embryos can be placed in a healthy woman without any problems?
The most healthy one is the placement of two embryos.This number should be a maximum of 3…
Who decides how many of these babies will be born in case of multiple pregnancy?
Of course, a surgical intervention to a person can be done with the consent of that person. There is nothing we can do without the mother's consent before babies are born. As a result, the mother's consent should be obtained and persuaded by law and ethically.
Multiple pregnanciesI give an example to the family:
“Look, now imagine that the Titanic is going down in your imagination. And four people try to get into a boat that only two people can ride, fight for life. If you put those four in the boat, it will be obvious that the boat will sink and die. Anlat If there is a quadruple pregnancy, I will tell the parents that this will create problems both in the health of the mother and the probability of four babies being born damaged is very high.Since the risk of preterm birth is very high, I suggest that babies may have brain hemorrhage, lung insufficiency and many other organ disorders, and that the risk of having disabilities that will affect them for a lifetime may be very high and at least two of them should be terminated for this.
We ensure that at least two babies are relatively healthy to maintain and be born. That is why we recommend that you selective reduction in pregnancies above two. As a matter of fact, it is a known fact that the continuation of the multiple pregnancy leads to the loss of the entire pregnancy by 5 percent.
Is it more successful or failure to hold more than one embryo?
Although one pregnancy Although it is successful, pregnancy above two is the shadow of this success.
What are your criteria when choosing embryos?
Usually we look at how symmetric and how fast the embryo is divided.
On the first day, we're looking at whether she's joined with a sperm and split. The first dividing embryos are considered healthier embryos. On the second day, we ideally want them to be four-celled, and we look at how symmetrically they are divided in shape and group them as first quality, second quality. Of course, the first quality of pregnancy is more likely to end. By the third day, we would ideally want them to be eight cells.
Again, their appearance must be symmetrical and well divided. But there is no valid method to fully evaluate the quality of embryos. In fact, a new method has been developed in America in the last 6 months. According to this method, the results of which will be taken within a few months, a very small drop is taken from the fluid in which the embryo lives and feeds. And by examining the wastes of this embryo in a sense, it is understood the metabolic activity of that embryo.
In short, we understand the metabolic activity from the wastes in the liquid in which the embryo lives. Thanks to this method, success can be increased to 60 percent with one embryo transfer and 80 percent with two embryo transfers. This means that if we can develop new methods, we can prevent multiple pregnancies beyond the chances of success in IVF.
At which stage is it decided to terminate the embryos?
When pregnancy occurs, each embryo may fall spontaneously in multiple pregnancies. This occurs at a rate of 20 percent and occurs within the first 6 weeks. So we wait for those stages to pass, and we usually do this selective reduction at the 9th and 10th weeks.
Is there any error in choosing a healthy embryo?
Of course there is. We can only look at the shape. However, we cannot know the true genetic analysis. Of course, the method we call genetic diagnosis before implantation can be used today. But that method is not 100% successful. Because at this stage we can look at a maximum of 9 chromosomes.
There may also be a defect in genes, even if the chromosome is intact. Furthermore, the cell we receive is normal but there are abnormalities in the other cells and an unhealthy baby may be born.
Anadolu Medical Center Women's Health Department Coordinator Dr. Aydın Arıcı replied to you…