Ethical dimensions of the number of embryos to be transferred in in vitro fertilization.
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.
Chervenak
F A
FA
Department of Obstetrics and Gynecology, New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York 10021, USA.
McCullough
L B
LB
Rosenwaks
Z
Z
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