title: Ethical dimensions of the number of embryos to be transferred in in vitro fertilization.
abstract: OBJECTIVE
  We propose an ethically justified policy for the number of embryos to transfer in an in vitro fertilization (IVF), by considering fourfactors: medical outcomes, patient's preferences, costs, and market forces of providers.
  
  
  METHODS
  We develop an ethical framework that incorporates three ethical principles: beneficence, respect for autonomy, and justice; and three professional virtues: integrity, compassion, and self-sacrifice.
  
  
  RESULTS
  This ethical framework calls for an informed consent process for IVF that provides: information about medical outcomes; information about the risks of multiple gestation; the opportunity to weigh the goal of pregnancy and live birth against the medical and moral risks of multiple gestation; evidence-based recommendations; protection of the woman from potentially coercive influences; and discussion of living with infertility and going to better centers.
  
  
  CONCLUSIONS
  The number of embryos to be transferred in IVF should mainly be a function of the pregnant women's informed decision. Limiting the number of transferred embryos to two in all cases is not ethically justified at this time.
authors.affiliation: Department of Obstetrics and Gynecology, New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York 10021, USA.
authors.forename: F A
authors.initials: FA
authors.lastname: Chervenak
authors.forename: L B
authors.initials: LB
authors.lastname: McCullough
authors.forename: Z
authors.initials: Z
authors.lastname: Rosenwaks
mesh_terms: D026686:Beneficence; D026688:Bioethical Issues; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D026684:Personal Autonomy; D011247:Pregnancy; D012935:Social Justice; D028722:Virtues