Triplets and embryo transfer policy.

The social and financial consequences of multiple pregnancies following embryo transfer have led us to question our policies and re-evaluate 'good practice' recommendations. A postal survey was carried out to assess current practice regarding embryo transfer policy and to understand the factors on which these decisions are based. The results demonstrated a wide variation in practice throughout the country despite the finding that most centres use the same criteria on which to base their decision to transfer either two or three embryos. Doctors seem to be the most influential individuals in the decision-making process, although when three embryos are transferred, the opinion of the patient is paramount. Patients are usually given information about the risks of multiple pregnancy but despite this, 69% felt that a multiple pregnancy would be the ideal outcome of in-vitro fertilization (IVF). It is strongly advised that patients are given more details of the consequences of multiple pregnancy and that centres which have a high multiple pregnancy rate adopt a policy of transferring only two embryos.