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Dr. James Grifo, director of the New York University Fertility Center, agreed doctors should avoid using more than three embryos. But he said it was warranted for some, such as older women with a history of failed treatment.

Grifo said the fact many Americans pay for their treatment out of pocket makes a big difference. “I spend a lot of time trying to talk patients out of the three-embryo transfer and you can’t always do it,” he said.

“My last set of triplets was a patient who demanded I put back three embryos,” he said.

Grifo said she wasn’t swayed by the data. “She delivered the triplets and they’re fine, but I wasn’t happy about it.”

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Online:

Lancet: http://www.thelancet.com/journals

CDC IVF info: http://www.cdc.gov/art/