Medical risks that should be considered before the transfer of more than one embryo are the higher rates of maternal, foetal, and neonatal complications (D’Souza et al., 1997; Makhseed et al., 1998; Pinborg et al., 2004; van Heesch et al., 2014; Li et al., 2015; Perkins et al., 2015; Bu et al., 2016; Santos-Ribeiro et al., 2016; Eapen et al., 2020; Gupta et al., 2020; Sites et al., 2020; Luke et al., 2021; Anzhel et al., 2022; Cirillo et al., 2022; Wang et al., 2022; Rodriguez-Wallberg et al., 2023).

Strong ⊕⊕⊕○

The GDG recommends that whenever the transfer of >1 embryo is considered, the patient should be provided with clear information about the higher risk of pregnancy loss, ectopic pregnancy, pre-eclampsia, gestational diabetes, antepartum and postpartum haemorrhage, Caesarean section, stillbirth, preterm birth, low birthweight, neonatal intensive care admission, and neonatal death associated with multiple pregnancies. The GDG also recommends that the patients sign an additional consent form if >1 embryo is transferred.

GPP