Should carrier embryos be transferred?

This is a decision for you, within whatever your local regulations permit, and it should be discussed before your cycle rather than when results arrive. ESHRE's position is that for autosomal recessive and X-linked recessive conditions, the carrier status of embryos may be taken into consideration for selection, depending on local regulations and following adequate counselling. The arguments in each direction: For transferring carrier embryos: a carrier child will be healthy and unaffected. Excluding carriers reduces the number of embryos available, sometimes substantially, which may mean fewer chances of pregnancy or additional cycles. Many people are carriers of something without knowing it. For preferring non-carriers where available: it avoids the child facing the same reproductive decisions you have faced. Where there are enough embryos, some couples prefer this and it is a reasonable preference. ESHRE also recommends that where unaffected embryos free of chromosome abnormalities are available, they are given priority for transfer. In practice, the question often resolves itself — if you have several unaffected embryos, non-carriers may be transferred first with carriers frozen. The dilemma is sharpest when carriers are the only unaffected embryos you have. Discuss this at the counselling stage and record your preference. Deciding under time pressure with results in front of you is harder, and clinics differ in their default policy.