ASRM Revises Guidelines On Limiting Embryo Transfer For Assisted Reproductive Technology Procedures To Reduce Multiple Births

The American Society of Reproductive Medicine and the Society for Assisted Reproductive Technology on Tuesday released revised guidelines for assisted reproductive therapies embryo transfer that recommend transferring no more than two embryos during a single procedure for women younger than age 35, Reuters reports (Reuters, 10/24). ASRM in 1999 released guidelines recommending the transfer of only two embryos for women younger than age 35 with a "healthy" prognosis and three embryos for women with a poorer prognosis for successful implantation. The organization in 2004 updated the guidelines to say that women under 35 with a good prognosis should consider implanting only one embryo (Kaiser Daily Women's Health Policy Report, 7/7). The new guidelines say that women under 35 should always be given no more than two embryos during a single implantation procedure "in the absence of extraordinary circumstances" (ASRM guidelines, November 2006). The guidelines also say that women ages 35 to 37 should receive no more than two to three embryos, that women ages 38 to 40 should receive no more than four and that women over age 40 should receive five or fewer embryos during an implantation procedure (Reuters, 10/24). "The evidence clearly indicates that we can reduce the number of high order multiple gestations and still maintain high pregnancy rates," Marc Fitz, chair of the ASRM Practice Committee, said, adding, "That is and will remain the goal of these guidelines" (ASRM release, 10/24). March of Dimes Medical Director Nancy Green in a statement said, "Limiting the number of transferred embryos will mean fewer higher order multiple gestations, defined as three or more fetuses, and reduce the risk of complications for both the mother and the fetus, including preterm birth." According to the March of Dimes, more than one-third of all pregnancies resulting from in vitro fertilization or another form of ART result in a multiple birth (March of Dimes release, 10/24).

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