Even those who are desperate to conceive a baby know that parenting is no easy feat. Parenting a singleton is hard enough work without the demands placed on parents by twins, triplets and other multiple sets. So, it’s no surprise to us when one of the first questions from our patients is regarding infertility treatments and their risk of conceiving multiples.
Does Participating in Infertility Treatments Mean I Might Have Twins, Triplets or More?
Multiple births are by no means a given of infertility treatments. However, some treatments put you at higher risk than others. Please note that at RRC, our doctors are first and foremost dedicated to the health and well-being of our mothers – and their baby – from the beginning of the mother’s fertility treatment to their exciting live birth at the end.
For this reason, we typically avoid any treatments that will place a patient at higher risk for a multiple birth. Multiple births are considered high-risk pregnancies by nature. Pregnancies in women who are 35+ are also considered high-risk. Therefore, our goal is to help each of our clients conceive healthy babies – one at a time!
With that said, let’s move on to the treatments that are more likely to create a multiples pregnancy scenario.
Drugs that trigger ovulation or superovulation. If you start by using a drug that stimulates ovulations – such as Clomid – there is no way to control the number of eggs released by your ovaries. If two eggs are released, you could conceive twins; if three are released, you may have triplets, etc. According to the American Society of Reproductive Medicine (ASRM), women who use fertility drugs with clomiphine citrate have a 5% to 12% chance of having twins and a 1% or less chance of having triplets.
Elective multiple IVF transfers. It’s no mystery that IVF is a cost-intensive procedure. For many couples, cost is the most prohibitive factor and, since IVF success rates are nowhere near 100% (yet!), this means most couples have to go through more than one IVF cycle in order to become pregnant. Since the more embryos that are implanted, the better chance there is of IVF success, some couples will opt to implant more embryos to increase their chances of success the first time around. However, there is also a much greater chance of having multiples if all of those embryos attach and make it through the pregnancy.
Day 2-3 embryo transfers. Until relatively recently, those of us who provide assisted reproductive technologies transferred the embryos when they were two to three days old. These embryos were only two to eight cells “big”! The more cells visible to our embryologist, the more successful they can be at selecting the most viable embryo. So, if there were 2- or 4-cell embryos available and the mother was in exceptional health, the doctor might opt to transfer more embryos to compensate for the lack of visible embryo viability. In most cases, only one – or none- of the embryos would attach and become a full-term baby. In others, two or more could potentially be successful – leading to a multiples pregnancy.
Blastocyst Transfer on Day Five Provides the Best Means Of Singleton Pregnancy Success
The wonderful news is that the evolution of culture media and modern technology make it possible for us to wait until Day 5 before transferring the blastocyst – an 8-cell embryo. This timeline is much closer to the natural human body’s timeline. If you were to conceive without ART, odds are your fertilized egg would emerge from the oviducts and into the uterus. Furthermore, your 5-day old blastocysts are large enough that our embryologists can do a better job selecting the most viable candidate for transfer. Together, these improvements make it increasingly possible for us to transfer a single embryo for a successful IVF singleton pregnancy. To date, Blastocyst Day 5 Transfers have allowed us to implant no more than two embryos per transfer for the last three years – and we’ve had the pleasure of watch 1400 babies come into the world as a result.
To learn more about enjoying the benefits of ART without the risk of multiples, contact RRC. We’re happy to let tabloid octuplets become a thing of the past!
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