For many, going through IVF and having embryos created poses certain questions and ethical dilemmas. A common question has to do with the number of eggs that are fertilised and the number of embryos created thereafter. While IVF works mainly as a selection process, choosing one embryo out of many which is more likely to implant, creating a number of embryos through this process leaves many with a feeling of unease about the future use of surplus embryos.

However, the chance of pregnancy after IVF treatment increases with increasing number of embryos, as embryologists are in a better position to select the most appropriate embryo for embryotransfer. This is especially important in advancing age, in cases of severe sperm pathology, as in azoospermia, as well as in treatments with pre-implantation genetic testing. In all these scenarios, as the possibility to find a healthy embryo to produce a pregnancy is lower on average, a higher number of embryos is required to make up for this.

A key factor that may be of help for those women and couples who wish to have so many of their eggs fertilised and not waste any embryos is the option of freezing eggs. This is having a number of eggs frozen at first place, rather than fertilise the total number of them. It can work great when a high number of eggs is produced and age is not advanced in a woman, as those cases with maternal age less than 35 years. Frozen eggs can be preserved safely for future use in case there is a need to.

Eventually, the wish to fertilise so many of the eggs produced during IVF treatment needs to be respected and put into the context of chances of getting pregnant with a certain number of fertilised eggs. The caring physician should counsel accordingly, taking into account a woman’s age, the presence of pathological conditions that require a higher number of eggs, such as endometriosis and severe male infertility problems. Should there be a surplus of unfertilised eggs these can be safely frozen for future use if need be.

©2021, Nicholas Christoforidis, Fertility Matters
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