After heated controversy last winter over the birth of octuplets conceived through in vitro fertilization, the American Society for Reproductive Medicine in October announced tightened practice guidelines and a willingness to work with policymakers to put teeth into its recommendations.

ASRM did not change its guidance on the number of embryos to transfer based on different patient prognoses. But it asked that doctors who exceed the recommendation transfer only one additional embryo, note the decision in the medical record and caution patients about the risks of multifetal pregnancies. The society said it is rare that patient circumstances will warrant exceeding its guidelines.

ASRM also said the number of embryos transferred should not differ based on whether they are fresh or cryopreserved, citing evidence showing that success rates are about the same.

In the octuplets case, patient Nadya Suleman said her physician transferred six frozen embryos, and two of them split.

"It is clear that these guidelines have a terrific impact on clinical practice," said R. Dale McClure, MD, ASRM's immediate past president. "Over the years, we have seen a reduction... see more