Comparison of two elective transfer policies of two embryos to reduce multiple pregnancies without impairing pregnancy rates

A first elective transfer policy of two embryos based solely on embryo morp hology was compared to a more restrictive policy transferring two embryos t o all patients aged <35 years with less than three previous cycles to reduc e the incidence of multiple pregnancies. With a significant reduction in th e number of triple transfers from 72.4 to 44.3%, the delivery rates were si milar for both policies, 31 and 32.1%. However, the multiple pregnancy rate s per transfer significantly decreased from 12.5 to 7.8% (P < 0.05). Of 99 pregnancies, only 24.2% were multiple including 1% of triplets compared to 40.7% multiple pregnancies including 6.7% of triplets for the first policy. Forty-eight transfers of two average embryos with the new policy were comp ared to 264 transfers of three average embryos with the old policy. Multipl e pregnancy rates per transfer were significantly reduced by a third from 2 3 to 8% (P < 0.05) without a reduction of the pregnancy rates (42 and 48%). This study demonstrated that elective transfer of two embryos reduced the number of multiple pregnancies without impairing the pregnancy rates even w ith the transfer of average embryos.