Does IVF Equal Twins, Triplets Or More?
In vitro fertilization (IVF) is an innovative technique to help couples who struggle to conceive. Infertility affects 8-12% of couples, and many turn to IVF for support. IVF is a multi-step process that involves hormone medication to produce multiple eggs. A fertility doctor or specialist then surgically extracts these eggs from the ovaries. Eggs are combined with sperm samples to create embryos, which are then transferred to the uterus. The success of IVF has also led single women and same-sex couples to leverage the treatment. A common concern and known risk factor of IVF is the possibility of conceiving with twins or more. This risk can be traced to fertility medication, but there are strategies doctors will use for IVF with singletons.
Are multiple births a big deal?
The idea of multiples, like twins, triplets, or more, sounds appealing to some couples who struggle to conceive. Multiple births, however, carry significant risks to mothers and growing babies. There is an increased risk of pregnancy complications. Preeclampsia and gestational diabetes are common conditions that can affect women. Labor also carries possible dangers like Cesarean sections, postpartum hemorrhage, or premature labor. The babies also run the risk of premature birth, low birth weight, developmental delays, and infant mortality. Multiple births also pose significant emotional, physical, and financial stress on women and families.
Why does fertility medication lead to multiples?
IVF requires the use of hormone medication at specific intervals to stimulate the ovaries to produce multiple eggs. Oral medications like clomiphene citrate stimulate ovulation, which can also lead to multiple eggs. Most IVF patients require injectable gonadotropins, which increase the concentration of hormones responsible for egg production. Should pregnancy occur at any time while on fertility medication, there is a chance of a multiple pregnancy. During IVF, when these eggs are combined with sperm to create embryos, these embryos also have a higher chance of developing into multiples. In addition to hormone medication, the number of eggs transplanted, embryo quality, and patient age all increase the risk.
How fertility teams reduce the risk of
Fertility clinics know this possible complication and implement strategies to limit the risk. Hormone therapy is closely monitored to prevent the premature release of eggs. Injectable medications are managed to limit overstimulation. After retrieving the eggs, additional steps drastically reduce the chance of multiples. Selecting the best quality embryos and opting for an elective single embryo transfer (eSET) will lead to higher rates of singletons. Screening embryos with preimplantation genetic testing (PGT) can identify genetic abnormalities that may lead to multiples. A combination of these strategies is essential for a successful IVF cycle.
An IVF cycle with a single child
Fertility medications during IVF can lead to multiple births. Hormone therapy significantly increases egg production, which can lead to multiples before and after implantation. While there are couples who will appreciate multiples, the health risks to the mother and children are high. Managing the hormone therapy and implantation process is crucial for limiting a successful IVF cycle to a singleton pregnancy.
