Is it safe to transfer two embryos in IVF?

From what I’ve seen, transferring two embryos can increase the chances of pregnancy for some couples, but it also increases the chance of twins, which is why a lot of clinics are more cautious about it now.

I used to assume “two embryos = double the chance,” but apparently it’s not that simple. Twin pregnancies can carry higher risks like premature birth, gestational diabetes, high blood pressure, and complications for both the mother and babies. That’s why many doctors now prefer single embryo transfer when there’s already a strong embryo available.

At the same time, I understand why some couples still choose two embryos, especially after multiple failed cycles, older maternal age, or years of infertility treatment. After spending so much emotionally and financially on IVF, people sometimes feel tempted to maximize the chances in one attempt.

From what I’ve read, the decision usually depends on things like embryo quality, age, medical history, and previous IVF outcomes rather than one universal rule for everyone.

If you too are keen on taking a chance on twins in IVF with two embryos, it is imperative that you weigh the risks and benefits of double embryo transfer (DET) after a detailed discussion with your doctor ahead of the procedure.

Traditionally, DET was done to improve the odds of implantation, but it was found to increase the risk of various neonatal complications.

According to a CDC report, the NICU admission for babies born from single embryo transfer is significantly lower as compared to those born from DET. One out of every 10 women with twin babies are more likely to have preeclampsia, high blood pressure, and other health complications.

Data indicates that transferring one fresh embryo followed by one frozen embryo has the best embryo outcomes without raising the risk of twins.

A different analysis also found that the transfer of two good-quality blastocysts provided a higher clinical pregnancy and live birth rates as compared to the transfer of a single embryo, but the multiple pregnancy rate was also higher.

Pros and cons of transferring two embryos in IVF

This decision should be made with your doctor after you consider these pros and cons of transferring two embryos:

Pros

1. Raises your chances of pregnancy
2. Saves both time and money
3. Can have twins, if you want

Cons

1. Risk of labor complications (such as labor and delivery bleeding and less than 29 weeks of gestation period)
2. Risk of gestational diabetes and pre-eclampsia (high blood pressure, high levels of proteins in urine, or other signs of organ damage)
3. Higher infant mortality rate
4. Possibility of cerebral palsy in babies
5. Children born with low birth weight or those born prematurely can suffer from both cognitive and emotional issues later in life