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American Society for Reproductive Medicine guidelines for number of embryos (fresh or frozen) to transfer

Characteristics	Number of cleavage stage embryos to transfer	Number of blastocysts to transfer
<35 years old, most favorable prognosis*	1 to 2 (1 recommended)	1
Other women <35 years old	≤2	≤2
35 to 37 years old, more favorable prognosis*	≤2	≤2
Other women 35 to 37 years old	≤3	≤2
38 to 40 years old, more favorable prognosis*	≤3	≤2
Other women 38 to 40 years old	≤4	≤3
41 to 42 years old, favorable prognosis and all others	≤5	≤3

IVF: in vitro fertilization.

* (1) first IVF cycle, good embryo quality, and sufficient excess embryos available for cryopreservation or (2) previous IVF success.
Transfer of additional embryos may be considered for women with a less favorable prognosis or who have failed at least two IVF cycles.
In donor egg cycles, the age of the donor is used to determine the number of embryos to transfer.
Since all oocytes may not fertilize with gamete intrafallopian transfer (GIFT), one more oocyte than embryo may be transferred for each prognostic category.
There are insufficient data to recommend a specific limit on embryos transferred in women 43 years of age or older.

Data from: ASRM Practice Committee. Guidelines on number of embryos transferred. Fertil Steril 2013; 99:44.

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