Double embryo transfer (DET) is often discouraged in surrogacy—but are there ever exceptions?In this follow-up to their powerful SET vs. DET conversation, Dr. Alyssa Small Layne welcomes back Dr. Erica Bove to explore the rare—but real—cases where two embryos might be transferred into a surrogate. Together, they explore age-based ASRM guidelines, the impact of embryo quality, endometriosis, failed cycles, and how patient history can influence decision-making.They also discuss surrogate qualifications, uterine environment, legal contracts, and the emotional nuances that make this one of the most complex decisions in modern family-building.What You’ll Learn:00:50 — Why single embryo transfer (SET) is still the gold standard02:04 — The ASRM exceptions for older eggs, day-3 embryos, or poor prognosis04:21 — How genetic testing changes the equation completely05:30 — 30–50% twin risk with two euploid embryos06:13 — Why most OBs are still “twitchy” about DET—even in IVF07:09 — Whether failed transfers or miscarriages justify DET08:13 — The miscarriage data no one talks about with twins09:08 — Endometriosis and embryo quality—even in a new uterus10:42 — Whether surrogate height or twin history matter (data vs assumptions)12:22 — Why surrogacy matching must include detailed contracts and expectations14:35 — The role of values, identity, and support in surrogacy decision-making16:44 — Why traditional fertility support groups don’t always work for surrogacy parents18:51 — The need for dedicated surrogate-focused support and coaching21:57 — The unseen stress surrogates face—and why they deserve emotional support too23:46 — How Dr. Bove’s coaching changed her practice and patient relationships26:52 — The #1 message Dr. Bove wants every intended parent to rememberResources Mentioned:Surrogate Vetting Essentials⁠⁠⁠⁠⁠⁠⁠BloomBridge Surrogacy App⁠⁠⁠⁠⁠⁠⁠ASRM Guidelines⁠⁠⁠Dr Erica Bove- ⁠⁠⁠Instagram⁠⁠⁠ and ⁠⁠⁠Website⁠⁠⁠Key Takeaways:Even in rare cases, DET requires deep evaluation of egg quality, age, history, and uterine environmentPGT-A tested embryos dramatically raise the chance of twins—up to 50%Height and prior twin deliveries may be helpful—but evidence is still anecdotalLegal contracts and clear emotional support plans are critical in complex surrogacy casesSurrogates deserve emotional care—not just medical clearancePlanning your embryo transfer? 📱 Use BloomBridge to plan your full journey—transfers, timelines, and emotional support included.“More efficient isn’t always safer. A single embryo transfer is still the best path to a healthy baby.”

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