Single embryo transfer with frozen transfer of all remaining embryos without further embryonic testing should be the standard of care in IVF

This year commemorates the 40th birthday of the first baby born through in vitro fertilisation (IVF).1 In its infancy, IVF was a procedure with low efficiency, applied mostly in women with tubal pathology and performed against the odds.2 In 1992, the introduction of intracytoplasmic sperm injection (ICSI) assisted men with poor semen quality to father a child.3 In the following decades, the effectiveness of IVF improved, with optimised stimulation, monitoring, and lab techniques resulting in a greater number of oocytes harvested, extra embryos transferred, and consequently more babies born per cycle begun.4Given the initial low success rates, the transfer of multiple embryos became the standard of care. Such embryo transfer policies subsequently resulted in higher rates of multiple pregnancies. Although a multiple pregnancy resulting in the birth of two (or more) healthy babies at or near term is in itself not a problem, the associated increase in maternal complications and poor neonatal outcomes resulted in a reduction of the number of embryos per transfer, and, more specifically, the introduction of single embryo transfers in many countries.4