We usually meet with the patient shortly before their embryo transfer for a brief pre-transfer consult. At that time we go over the progress of the cycle up to then, including the factors leading us to do IVF, the number of eggs retrieved, the percentage that fertilize, and the development to that point of the embryos. Depending on a lot of factors, including prior history, age of the person at the time of egg retrieval, cell division and fragmentation of the embryos and results of prior cycles, we discuss the options for the number of embryos to transfer. Usually this is two to four embryos. Remember that the sum total of just about any IVF cycle is a small core of good embryos and it is from these embryos that we got our pregnancies.
In the early 1990’s, it was not uncommon to transfer seven, eight or nine embryos. The relatively low implantation rates of embryos at the time warranted being quite cavalier about putting a large number back. Thankfully, in vitro fertilization has progressed to where we can usually competently maximize a chance for becoming pregnant by putting back no more than four or five embryos. Thankfully in many cases we can put back two embryos and still insure a very high likelihood of the cycle working. In our hands, two embryo transfers on Day 3 are a very viable option in many couples. After the decision for the number of embryos to transfer has been made, we escort the patient to the procedure room. This is the same room where the egg retrieval occurred. It is right next to the embryology laboratory.