Be Blog

Single Embryo Transfers: Prioritizing Wellness and Education

multiple pregnancies

A surrogacy journey is a unique voyage in that it combines many facets – scientific, emotional, legal and logistic. Most intended parents arrive to our first consultation overwhelmed by all the information out there, unable to get a clear and concise picture of how to create their family ethically, legally and safely. Our task as an agency is to carefully assess each intended parent’s unique case and provide guidance that values health above all.

Agencies must recognize that intended parents are a vulnerable group – often drained by a series of past failures, misled by surrogacy myths, and out of their depth trying to comprehend the complex world of IVF. For this reason, it is our obligation to provide you with transparency and education on the best clinical practices so you can make informed decisions regarding your surrogacy journey’s design.

Deciding on the number of embryos to transfer at one time is a major decision intended parents must make once the embryo creation phase of the journey is complete. On the surface it might appear that a double embryo transfer would bring a better chance of success or that twins could be a quick way to complete family planning, but in reality transferring multiple embryos involves high stakes and repercussions. Over the last twenty years, this practice has been the focus of campaigns for change, due to the serious health implications of multiple births.

Multiples are risky

It is widely understood that multiple birth brings with it a prevalence in complications and long-term health issues, both for babies and surrogate carriers. Due to the record numbers of double (even triple) embryo transfers in the 1990’s, multiple births have become the greatest health and safety risk in IVF. One quarter of all IVF births resulted in twins during this decade, and with this, also a high incidence of critical deliveries, disability, stillbirth and neonatal death.

Statistical findings from HEFA’s report on ‘Multiple Births in Fertility Treatment’ states that twin babies are:

• Four times more likely to not survive pregnancy
• Six times more likely to suffer from cerebral palsy • Seven times more likely to die shortly after birth
• Ten times more likely to be admitted to NICU

Along with the babies they are nurturing, surrogate carriers are equally placed at risk if carrying twins and are more likely to experience high blood pressure, pre- eclampsia, late miscarriage and haemorrhage.

‘One at a Time’ launch

Introduced in 2007, the “One at a Time’ campaign urged clinicians to transfer single embryos only, spurring a decline in multiple births from 28% to only 6% over the span of the last two decades. Choice IVF clinics have reacted to the these types of campaigns and their findings and have begun restricting multiple embryo transfers to patients over the age of 37 or with low quality embryos or refusing them altogether.

‘Double the Success’ myth

The belief that double embryo transfers increase the odds of pregnancy has been dispelled as IVF birth rates have risen overall while multiple births have significantly declined as a result of campaign outreach. The correlation between multiple embryo transfers and live birth is now outdated; increased rates of success are attributed instead to improved embryo growth at transfer, such as waiting for the day 5 ‘blastocyst’ stage of development.

Where we stand

Be Parent supports single embryo transfers in the endeavour to make surrogacy as safe as possible for all parties involved. While we strive to adapt all of our programs to the individual needs of our patients, we are committed to protect our intended parents, who are trusting our guidance, our surrogate carriers, who are placing their health on the line, and mostly our babies born, who are the whole reason we are here.

To find out more about Be Parent’s best practices please contact our support team at Additional information on multiple embryo transfers can be found in the recently released report from 2019 – Multiple Births in Fertility Treatment on the HEFA website


oto mekhashishvili