Guidelines for the number of embryos to transfer following in vitro fertilization.
OBJECTIVE
To review the effect of the number of embryos transferred on the outcome of in vitro fertilization (IVF), to provide guidelines on the number of embryos to transfer in IVF-embryo transfer (ET) in order to optimize healthy live births and minimize multiple pregnancies.


METHODS
Rates of live birth, clinical pregnancy, and multiple pregnancy or birth by number of embryos transferred are compared.


RESULTS
Clinical pregnancy, multiple pregnancy, and live birth rates.


METHODS
The Cochrane Library and MEDLINE were searched for English language articles from 1990 to April 2006. Search terms included embryo transfer (ET), assisted reproduction, in vitro fertilization (IVF), ntracytoplasmic sperm injection (ICSI), multiple pregnancy, and multiple gestation. Additional references were identified through hand searches of bibliographies of identified articles.


METHODS
Available evidence was reviewed by the Reproductive Endocrinology and Infertility Committee and the Maternal-Fetal Medicine Committee of the Society of Obstetricians and Gynaecologists of Canada and the Board of the Canadian Fertility and Andrology Society, and was qualified using the Evaluation of Evidence Guidelines developed by the Canadian Task Force on the Periodic Health Exam.


RESULTS
This guideline is intended to minimize the occurrence of multifetal gestation, particularly high-order multiples (HOM), while maintaining acceptable overall pregnancy and live birth rates following IVF-ET.
Min
Jason K
JK
Ottawa ON.
Claman
Paul
P
Ottawa ON.
Hughes
Ed
E
Hamilton ON.
D000328:Adult; D000367:Age Factors; D002170:Canada; D004624:Embryo Transfer / Q000592:standards*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods / Q000592:standards*; D006801:Humans; D009774:Obstetrics / Q000592:standards*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D012955:Societies, Medical