Jun 24, 2026 · 1 hr 3 min · 10 segments
If IVF is so expensive, why would a fertility clinic recommend transferring just one embryo instead of two? It's a question many intended parents ask. After all, if you're investing so much time…
Julian EscobarGuest
Whitney HallHost
I know you've kind of already brought it up, and I'm so excited to get into this because for many years, it wasn't uncommon that you were to do multiple embryos during IVF.
But many patients, I think, still assume that transferring more embryos means a better chance of success.
What has changed in the fertility medicine that led to that shift towards a single embryo? I know you already said you would have done things differently now if you were doing this process now.
Well, again, like we said before, ignorance is bliss and medicine is decisions.
IVF really improved in the past 14 to 10 years okay and so so it became much more efficient and it was like this kind of mixture of things where you come we steam you we cannot steam you too much because you'll hyperstem and your lining won't look good because we're doing fresh embryo transfers and then of course then you're trying to get a lot of eggs but you can't and sorting it out and then we realized that really what got you pregnant was the quality of the embryo.
And so then the ability to split the process, get a lot of eggs, maximize the egg retrieval process, get a lot of eggs, good eggs, make good embryos, test those embryos, and then being able to then just focus on the lining and the uterus and transferring a good embryo, that was better than the jumbo that we had before.
And And so as pregnancy rates increased, people didn't change the behavior of how many embryos we were transferring.
And very quickly, the studies that showed that transferring two embryos increased the chance of fetal death by like 400% and complications of pregnancy in 600%.
So that's when the ASRM in 2017 passed the guidance to just do single embryo transfers in certain circumstances.
But it went from like a suggestion to a guidance to this is what you should be doing, blah, blah, increasing.
And then two years later, it even passed for gestational carriers, where it's very specific.
I know you've kind of already brought it up, and I'm so excited to get into this because for many years, it wasn't uncommon that you were to do multiple embryos during IVF.
But many patients, I think, still assume that transferring more embryos means a better chance of success.
What has changed in the fertility medicine that led to that shift towards a single embryo? I know you already said you would have done things differently now if you were doing this process now.
Well, again, like we said before, ignorance is bliss and medicine is decisions.
IVF really improved in the past 14 to 10 years okay and so so it became much more efficient and it was like this kind of mixture of things where you come we steam you we cannot steam you too much because you'll hyperstem and your lining won't look good because we're doing fresh embryo transfers and then of course then you're trying to get a lot of eggs but you can't and sorting it out and then we realized that really what got you pregnant was the quality of the embryo.
And so then the ability to split the process, get a lot of eggs, maximize the egg retrieval process, get a lot of eggs, good eggs, make good embryos, test those embryos, and then being able to then just focus on the lining and the uterus and transferring a good embryo, that was better than the jumbo that we had before.
And And so as pregnancy rates increased, people didn't change the behavior of how many embryos we were transferring.
And very quickly, the studies that showed that transferring two embryos increased the chance of fetal death by like 400% and complications of pregnancy in 600%.
So that's when the ASRM in 2017 passed the guidance to just do single embryo transfers in certain circumstances.
But it went from like a suggestion to a guidance to this is what you should be doing, blah, blah, increasing.
And then two years later, it even passed for gestational carriers, where it's very specific.
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