BONUS 238: How to Determine the Number of Embryos to Transfer

December 20, 2019

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

Episode Sponsor:

Fertility Centers of Illinois

Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Angie has been trying to conceive for over two years. She and her husband are healthy and fit but have unexplained infertility. After seven failed IUIs, she wonders if there are other tests or IUI protocols to consider and whether they are good candidates to move on to IVF.
  • Yulia is single and 32 years old. Since doctors in three different countries have no explanation for her lack of regular periods, she asks if FHA and PCOS can coexist and be the likely reason for her amenorrhea.
  • Erica has a lean PCOS diagnosis. She has confusing blood work results and many follicles. She asks what might be going on and how these conditions might impact her treatment.
  • Michele asks about the new study results recently released for surgical and medical treatment plans based on the ReceptivaDx test.
  • Lucia hasn’t seen a specialist yet, after trying for nine months. Her charting shows signs of a luteal phase defect. She asks if she could have a progesterone issue and if a definite temperature shift always signals ovulation.
  • Krysten (35) has had three healthy pregnancies, which resulted in her three children. In trying for her fourth child, she’s had losses due to miscarriage and a blighted ovum, both of which resulted in D&C procedures. She asks if any further tests should be run and if her age and egg quality could be the problem.

Dr. Rodgers and Heather continue the episode by discussing the current guidelines around the number of embryos to transfer:

  • In April 2017, the American Society of Reproductive Medicine released an updated guideline on the number of embryos to transfer. We’re going to talk about their recommendations in detail, but overall, what is the goal of these guidelines?
  • What are cleavage-stage embryos versus blastocysts?
  • What role does preimplantation genetic testing play in the new guidelines?
  • Please describe what a “favorable prognosis” means.
  • What are “other scenarios” not included under the favorable prognosis category?
  • Take us through the guidelines in detail.
  • Do the guidelines differ for donor eggs? Please explain.
  • Do the guidelines differ for frozen embryos? Please explain.
  • Since these guidelines were released, in your opinion, have most U.S. clinics followed them? Give us an overview of the current landscape.
  • These are guidelines, which means the final decision is up to the patient. Is that correct? Please explain.
  • After how many failed transfers do you recommend not following the guidelines? Please explain.
  • Does the SART data and your personal experience since the guidelines were released indicate these recommendations result in successful live births? In other words, what would you tell patients who are nervous about transferring only one embryo?
  • Is there anything else you’d like to add?
  • What words of hope would you offer to patients who are starting their first or next IVF cycle?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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