Surrogates! You don’t need to transfer two embryos.

As Forward Fertility as your agency, our parents-to-be plan to transfer one embryo at a time. This is not always the case at every agency or IVF clinic.

Why transfer one embryo at a time?

The short answer to ‘why transfer a single embryo’ is for the safety and well being of the surrogate and the baby.

When the lovely, smart, healthy women of Wisconsin, Illinois, Minnesota and Iowa apply to be a surrogate, they have questions about the process and their safety.  Even more so, the partners and support system for the surrogate have questions about safety. It’s one of the biggest concerns we hear from partners of surrogates.  We hear you, partners!  We are concerned for the surrogate’s safety, too.  That is why Forward Fertility takes on clients who plan to transfer one embryo at a time.

Specific risks of multiple pregnancy

A pregnancy of twins, triplets, or more have more risks.  These risks are well documented – here are a few:

  • Preterm labor and birth – 60% of multiple pregnancies are delivered early – putting the babies at risk for conditions such as, but not limited to, respiratory distress, cerebral palsy, bleeding around the brain, life long vision problems, feeding issues, and NICU stays.
  • High blood pressure – gestational hypertension, pre-eclampsia, eclampsia, HELLP syndrome
  • Anemia – twice as likely in multiple gestation.
  • Birth defects – multiple birth babies have twice the rate of congenital anomalies (i.e., spina bifida).  IVF pregnancies (even singletons) already have higher rates of birth defects (i.e., cardiac).
  • Pregnancy loss – twin pregnancies have a higher rate of miscarriage than singleton.
  • Difficult Post-partum recovery.  More weight to lose, often recovery from a C-section, abdominal muscles need more recovery, bladder control issues.

But, transferring two embryos will save us money or allow us to form our family more quickly.

As parents, the draw to have two babies ‘at the same time’ for ‘a similar cost’ may seem appealing.  However, given the risks listed above, parents need to ask themselves….

Would you match with a surrogate who would have a health history or behavior that would INCREASE the risk for any of the above complications?  Probably, not.  Surrogates and their partners and support people feel the same way.

You don’t need to transfer two embryos. Single embryo transfer is the medical Standard of Care

When you’re working with an IVF clinic that will only transfer 1 embryo at a time into a surrogate, this is a sign you’re working with a quality facility.  According to the 2019 CDC data on Assisted Reproductive Technology, Single-embryo transfer (SET) rates among all embryo-transfer procedures were 80.6% among women aged <35 years, 79.5% among women aged 35-37 years, and 72.4% among women aged >37 years.

The standard of care, when high quality embryos are being used, is to transfer one embryo at a time.  Many IVF clinics will not transfer two embryos into a surrogate.

Dr. Kelly Lynch, with the American Society for Reproductive Medicine, has a short video explaining the risks of multiple pregnancy.  Watch the video  here.


Embryo Splitting – Identical Twins with IVF

That said, it’s important to note that in 1-3% of IVF pregnancies, the embryo will split to identical twins. So, the chance of carrying twins is not ZERO, even if you only transfer one embryo.  In the case you do carry twins, you do receive additional compensation.

As a surrogacy agency, we know that surrogate applicants and parents both want this process to work the first time.  For that reason, we take on clients and specifically work with certain clinics who we believe should have a good chance of success.  The ASRM (American Society for Reproductive Medicine) guidelines state that with a good prognosis (based on embryo quality and the recipient candidate), a single embryo should be transferred.

Since 2017, Forward Fertility has not taken on any clients who plan to transfer more than 1 embryo and does not work with clinics that transfer more than 1 embryo into surrogates. As IVF clinic laboratories have improved their practices for fertilizing eggs and growing embryos, the success rates with IVF have improved greatly and transferring more than 1 embryo is not as necessary as it was when IVF clinic success rates were not as high.

As an agency, watching the carrier and parents going through that process, Forward Fertility decided double embryo transfer would not happen again, to protect the surrogates, parents, and baby.  Many women considering surrogacy in Wisconsin find great relief to know that they will not be asked to transfer two embryos.

Forward Fertility Goals

As a surrogacy agency in the Upper Midwest, our goal is to have healthy surrogates and healthy babies, one at a time.  We partner with IVF clinics that have excellent success rates, so that one embryo sticks and one healthy baby is born.  Click here to learn more about being a surrogate with Forward Fertility.  We can’t wait to meet you.