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ASRM 2017 Committee Opinion on the limits to the number of embryos to transfer

ASRM 2017 Committee Opinion on the limits to the number of embryos to transfer
Prognosis Age (years)
<35 35 to 37 38 to 40 41 to 42
Cleavage-stage embryos
Euploid* 1 1 1 1
Other favorable 1 1 ≤3 ≤4
All others ≤2 ≤3 ≤4 ≤5
Blastocysts
Euploid* 1 1 1 1
Other favorable 1 1 ≤2 ≤3
All others ≤2 ≤2 ≤3 ≤3
Other favorable include any ONE of these criteria:
  • For fresh cycle: (1) expectation of one or more high-quality embryos available for cryopreservation, or (2) previous live birth after an IVF cycle.
  • For frozen embryo transfer cycle: (1) availability of vitrified day 5 or day 6 blastocysts, (2) euploid embryos, (3) first frozen embryo transfer cycle, or (4) previous live birth after an IVF cycle.
Justification for transferring additional embryos beyond recommended limits should be clearly documented in the patient's medical record.
ASRM: American Society for Reproductive Medicine; IVF: in vitro fertilization; FET: frozen embryo transfer.
* Demonstrated euploid embryos, best prognosis.
¶ Other Favorable = any ONE of these criteria: Fresh cycle: expectation of 1 or more high-quality embryos available for cryopreservation or previous live birth after a prior transfer with sibling embryo(s); FET cycle: availability of vitrified day-5 or day-6 blastocysts, euploid embryos, first FET cycle, or previous live birth after an IVF cycle.
Reproduced from: Practice Committee of the American Society for Reproductive Medicine, Practice Committee of the Society for Assisted Reproductive Technology. Guidance on the limits to the number of embryos to transfer: committee opinion. Fertil Steril 2017; 107:901. Table used with the permission of Elsevier Inc. All rights reserved.
Guidance reaffirmed in: Practice Committee of the American Society for Reproductive Medicine, Practice Committee of the Society for Assisted Reproductive Technology. Guidance on the limits to the number of embryos to transfer: a committee opinion. Fertil Steril 2021; 116:651.
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