Today many multiple pregnancies are the result of fertility treatment. For couples who have been childless for long, the prospect of twins or triplets may seem ideal at first after the long wait to be parents. But the complications of multiple pregnancies are likely to affect both mother and babies in the form of maternal and fetal complications in addition to financial strains, physical exhaustion and emotional upheavals.
In-Vitro fertilization and Multiple Pregnancies
In-Vitro fertilization (IVF) itself is an overwhelming experience; add to that is the risk of multiple pregnancies. In the course of IVF, multiple pregnancy rates can be as high as 20% as compared to 2-3% multiple pregnancy risk among the general population. Out of this, approximately 2-3% results in triplets and even quadruplets. Twins are the most common outcome of a multiple pregnancy.
Data from the USA (SART 2002) regarding multiple pregnancies showed that 32% of deliveries after in-vitro fertilization were twins and 7% were triplets or more. In the United Kingdom (HFEA patient's guide 2002), 25% of deliveries after IVF were twins and 1.7% were triplets.
Why does fertility treatment increase the likelihood of having twins?
During IVF treatment usually more than one embryo is implanted to maximize the chances of a successful pregnancy. Thus multiple embryos increase the chance of a multiple pregnancy. As the frequency of multiple pregnancies radically increased, the Human Fertilization and Embryology Authority (HFEA) decided to impose a limit on how many embryos could be transferred at one go, during IVF treatment. Now the maximum embryos that could be transferred is two for women under the age of 40 and a maximum of three for women aged 40 or over who are using their own eggs.
Different countries have different rules and restrictions with regard to the number of embryos to be transferred. In the United Kingdom, in order to reduce the risk of multiple pregnancies, the HFEA (August 2001) has decided to reduce the number of embryos to be transferred from three to two. A three embryo transfer may be performed in exceptional circumstances.
The Risks of Multiple Pregnancies
While IVF is a highly effective option for couples desiring children, when considering this line of treatment, couples should have a clear understanding of the possibility of multiple pregnancies and what steps would be taken if such an event would occur. The most common complication associated with multiple births is premature birth. Twins, triplets, and other multiple-birth children are at much higher risk of premature or low birth weight apart from a host of other health challenges. There is also a greater risk of birth related complications or even miscarriage. The other medical conditions that are likely to occur during a multiple pregnancy include gestational diabetes, preeclampsia, and fetal growth problems.
Because of these concerns, couples considering infertility treatment need to not just evaluate the overall ‘success’ rate of a fertility clinic when deciding where to go for treatment but also take into account the clinic’s rate of twin and triplet births into consideration. It’s also pertinent to locate the most suitable health care professionals who have experience with multiple births. As multiple pregnancies are regarded as high-risk, the need for specialized health care becomes vital to ensure the well-being of mother and babies.
East Bay fertility clinic specializes in the comprehensive evaluation and treatment of infertility, providing a complete mind-body experience for fertility couples. We encourage couples to undergo intensive counseling on the possibilities and risks associated with multiple births.
Our experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. A former infertility patient herself, Dr. Snowden brings to her patients a rare and valuable firsthand empathy for the personal pain and emotional stress of dealing with infertility.
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