IVF and double embryo transfers what does it mean for me?

Did you know that as fun as it is to have two babies at once, there are some increased risks with multiple pregnancies?

IVF success is measured by the delivery of a healthy baby.  In order to do this many IVF clinics will transfer two or more embryos to try and increase the success of a pregnancy and a birth of a single baby.

But replacing more than one embryo only increases the rates of multiple pregnancies, by around 10%.

A study by Martikainen, et al, 2001, concluded that the success rate of a single embryo transferred was not significantly much lower than those who had a double embryo transfer.  They found that the difference was only by 10%.

Did you know that multiple pregnancies:

  • Increase the risk of premature birth, or very low birth weights by around 48%
  • Complications of one or both babies during the pregnancy intrauterine with growth
  • Increases chances of hypertension and reduces the ability for a natural vaginal birth by around 71%

According to a 2018 study by Abuzeid et al, twin pregnancies have a six-fold increased risk of one or more of the babies not making it to term, and an increased risk in development of cerebral palsy compared to a single pregnancy.

Clinics in the UK and Europe are monitored to keep twin pregnancy rates under 10% in the UK, and in Europe around 11%.  In Australia there are voluntary clinical guidelines around single embryo transfer, and it is recommended by the governing bodies that no more than one embryo is transferred at a time without affecting clinical pregnancy rates.

Over the years in IVF the replacement of one embryo has become much more favorable as a safe clinical option, and pregnancy rates have improved indicating that over time culture mediums and lab practices have improved the embryo quality, leading to a higher chance of a take home baby per cycle.

When would I look at discussing with my specialist about having more than one embryo replaced?

  • After multiple unsuccessful IVF cycles
  • Over the age of 35
  • Embryos transferred on days 2 or 3
  • Poor quality embryos
  • Previous double embryo transfers that were unsuccessful
  • Embryos frozen using slow frozen techniques
  • Over the age of 35 and never been pregnant
  • If no more funding for cycles and having a healthy mum

What are the cons for a mum having twins?

  • Increased chances of gestational diabetes (see gestational diabetes blog)
  • Increased financial burden, the cost of one baby is expensive but the cost of two is double!
  • Increased stress being a new mum and adapting to two babies
  • Increased risks of high blood pressure and preeclampsia

What are the pros of having twins?

  • Two at once and if you only want two children family completed at once
  • The costs of IVF cycles up until that pregnancy, and no need to go back again for multiple cycles
  • A play mate for the other
  • Only need to go through child birth once

When considering if double embryo transfer is for you, make sure that you are fully informed by your specialist about the pros and cons when carrying multiple babies.  Make sure that you are fully informed, and clearly understand and feel comfortable with your decisions.


Abuzeid, O,M., Deanna, J., Abdelaziz, A., Joseph, S, K., Abuzeud, Y, M., Salam, W, H., Ashraf, M., and Abuzied, M, I 2017. The impact of single versus double blastocyst transfer on pregnancy outcomes: A prospective, randomized control trail. ‘Facts views visions obstetrics, gynecology and reproductive health’. 9:4, 195-206

Martikainen, H., Tiitinen, A., Tomas, C., Tapanainen, J., Orava, M., Tuomivaara, L., Vilska, S., Hyden-Granskog, C., Hovatta, O 2001. One versus two embryo transfer after IVF and ICSI: a randomized study. ‘Human Reproduction”. 16:9, 1900-1903

Wang, J., Lane, M and Norman, R,J., 2006.  Reducing multiple pregnancy from assisted reproduction treatment: educating patients and medical staff. ‘Medical Journal Australia’. 184:4, 180-181


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