The Creating a Family show yesterday was on Preventing IVF Failures. We talked about the amazing success rates that can be achieved with IVF now, and yet the rate of twins is still stubbornly high in the US. It made me pause again after my blog yesterday (Twins are Cool. How Can We Adopt Them) and assess how much of the twin pregnancies after IVF are due to patient pressure?
How Common are Twins after IVF
The rate of twin births increased by 70 percent between 1980 and 2004, but have leveled off since. Over 40% of births after IVF are twins.
Risk for Twin Pregnancies
While most twins will eventually do fine, I think we tend to underestimate the risk to the babies and mother in twin pregnancies.
- About 60% of twins will be born premature.
- About half of all twins will be born with low birth weight.
- The risk for cerebral palsy is 4 times more likely to occur in twins.
- Twins are at an increased risk for increased risk of being in the Neonatal Intensive Care Unit.
- Twins are more likely to have intellectual disabilities.
- Twins are at an increased risk for vision and hearing loss.
- Women expecting twins are more than twice as likely as women with a singleton pregnancy to develop preeclampsia.
- Women pregnant with twins are more likely to develop gestational diabetes.
Good News
In the past, infertility patients were often faced with the difficult decision of having to accept a lower success rate if they chose single embryo transfer over transferring two embryos. Not so now.
According to Dr. Sonia Elguero, an infertility doctor with Boston IVF, your chances of pregnancy are about the same if you transfer two embryos at the same time or transfer one embryo and freeze the remaining embryo, to transfer if the first transfer does not implant. I suspect the healthy baby rate is higher for the two single embryo transfers than for the two embryo transfer. She did note that the age of the mother had to be taken into consideration when making this decision.
If you’re thinking about IVF, you will enjoy this show on how to make sure you have the greatest chance of success.
How many embryos did you transfer? Did you worry about the risk of twins or were you secretly hoping for a twin pregnancy?
Image credit: Bobokeh Source for risk of twins: www.marchofdimes.com
So after listening to the podcast, I still say the cost of IVF is the main driver of twin/multiple pregnancy. I recently went to a conference about ART, and there was a RE researcher that said the same thing. He urged that we lobby for insurance coverage on infertility treatment so that the patients feel like they can select single embryo transfer.
I have to listen to this one and come back to comment. But to share my experience…when we started ivf, I was 37. I went in for a consult and when it came to discussion about how many to transfer, I said I wanted a single embryo transfer, primarily because I listened to your shows. But the doctor showed us a chart of what was recommended by age, and for my age it was 2. Dr said we can do one but the chances of failure is greater than getting twins or multiples. We were paying out of pocket so we agreed to transfer 2. I agree with previous comments, cost is one of the biggest factor. We cannot afford many failed cycles. And on the most part, I think RE are primarily concerned about getting you pregnant.
Our first try we transferred two and weren’t too concerned about the possibility of twins. We only had one to transfer on our first frozen attempt. Our most recent attempt saw 3 transferred, and honestly I was worried about multiples. But by that point I was willing to be happy with whatever happened. None have taken so far, unfortunately.
Our clinic really emphasized the increased risks associated with twin pregnancies. That combined with my age (32) and the fact that we have insurance coverage for IVF made it easy for my husband and I to choose single embryo transfer. It worked – we are now 12 wks pregnant!
Congratulations, Sarah T!
Loved, loved this show. They’re all good, but this one was great timing. It is good to know that science is making progress. It gives me hope for my next cycle and i need some hope right now.
I think we love twins in America (and probably especially those families who have struggled with infertility). I love twins too and we have them in our family…my mom was a twin of two girls, her niece had boy/girl twins and her great-niece had boy/girl twins too. I didn’t know about health risks to twins until you had shared about it here and I found out recently that my little cousin couldn’t take a certain job because of a problem with her back/spine because her twin brother had smushed her there in utero.
I think having the success rate for transferring one embryo be the same as transferring two could help with families choosing to do that. The cost of IVF could affect that and if two cycles cost more than one… I don’t personally know about that. In any case, it is helpful for you to have shared about this with women considering IVF 🙂
Kristine, GREAT point about cost! I know some clinics make the cost the same (basically don’t charge for the frozen embryo transfer for patients that elect to do a single embryo transfer.) More should do this. I’d love to know how many clinics make the cost the same.
My older adoptive siblings are twin (fraternal M/F). They only weighed 4lb (M) and 2lb (F) at birth. They are healthy adults now although I do feel that there might have been some effect on my sister.
My younger twin biosiblings were either stillborn or died at birth (am unsure which). Other things (which I won’t go into here) make me wonder whether that pregnancy might have been more successful if it had been a singleton one.
So even though most twins I know are healthy, I can see that that isn’t always the case. Of course, the above cases are a long time ago and it is quite possible that my own bsiblings might have lived if born today – who knows.
cb, from where I sit, I hear more of the pregnancy and birth complications than the average person. I also hear some about the learning difficulties that can show up with some premies as they reach school age.
I am an identical twin. We have been going to Twins Days in Twinsburg Ohio for the past 31 years. When you look at the stats of the types of twin sets that attended the largest group by far are fraternal under 10. I don’t think the has been a study about why that group is so large . But I think we can assume that fertility treatment might have something to do with it.
Without a question, infertility treatment is the cause of the large increase in non-identical twins in the last 10 years.
We have friends who after fifteen years were finally blessed with twins. They were born at 38 weeks. Their little girl was born weighing at 7 lb 6 oz. and their little boy was born weighing at 6 lb 8 oz.
Given the number of infertility treatments they were forced to endure and the number of failed adoptions they were forced to endure, are we really going to criticize them in their efforts to grow their family?
Jane, the need to educate about the risk of attempting for twins is not about criticizing, but about educating. First, in your friends case, we don’t know her age, nor the quality of her embryos, so it might well have been medically advisable to transfer two. However, the need to educate infertility patients is huge.
I’m thrilled your friend’s children were born healthy, but others are not and parents need to consider the risk to make an informed decision of whether they are willing to run the risk.