Infertility treatment has resulted in a significant increase in multiple pregnancies, including higher order multiples (triplets, quadruplets, quintuplets and more). The American College of Obstetricians and Gynecologists reports that multifetal pregnancies increase both maternal and neonatal morbidity and mortality. High-order multiple pregnancies present higher risks than twin pregnancies.
Most women pregnant with triplets or more will be faced with the decision of whether to abort one or several of the fetuses to reduce the pregnancy to a twin or singleton pregnancy. This is known as selective fetal reduction or selective abortion.
Many higher order multiples and even twin pregnancies can be avoided by careful decision making about whether to use injectable fertility medications, such as gonadotropins, with intrauterine insemination (IUI) and how many embryos to transfer in IVF treatment. Patients must be educated on the risks of multiple births before they discuss these decisions with their fertility doctor.
Making this decision is very hard for most women and couples. This difficulty is made all the harder because there are not many places to turn for accurate information. Creating a Family has resources on selective fetal reduction. A few we think you will find particularly helpful are:
- Fetal Reduction to Reduce Risk of Triplets and More (1 hr. radio interview with experts)
- Selectively Reducing a Twin Pregnancy to One (blog)
More Creating a Family radio interviews with experts, videos, blogs, fact sheets, and Q and A’s with Experts on selective fetal reduction can be found at the icons below.
Sources: Creating a Family radio shows below; www.acog.org/
Image credit: Hejma