Acceptable when desired or a complication preventable through elective single embryo transfer?

The title above was essentially the title of an editorial in a major infertility journal (Fertility and Sterility) in February 2018. Many patients who have been trying to get pregnant for so long want twins. However they often don’t understand the medical complications for the babies and sometimes for the mother of a twin pregnancy.

The biggest risk of a twin pregnancy is that the babies may be born prematurely. Twelve percent of twin pregnancies are born before seven months, and these babies often have significant problems, needing a long hospital stay, sometimes with a breathing tube and often surgeries. They cannot go home right away after birth, a disappointment for the parents. Twins also have a higher chance of dying at birth or shortly after than a single baby.

Fifty-eight percent of twins are born before eight months. We now know that even babies born 2-3 weeks before the due date (most twins are) have a higher rate of newborn complications and mild learning deficits. The impact of a handicapped child on the entire family is significant.

Women with twins often need to be on bedrest for a number of weeks in the pregnancy. They are at a higher risk of high blood pressure and diabetes during the pregnancy. They are even at a higher risk for dying than a woman with a single pregnancy.

Putting IVF twin pregnancy behind us

Years ago success rates for in vitro fertilization (IVF) programs were not as good as they are these days, and often multiple embryos were transferred in order to try and increase the success. However in recent years in good IVF centers, pregnancy rates are very good with elective single embryo transfers (eSETs) in select groups of women. These include women under the age of 38 using their own eggs, women of all ages transferring a genetically normal embryo as determined by PGT (preimplantation genetic testing), and women of all ages who use a donor egg.

At RSC we have had excellent pregnancy rates with eSET in women in these categories. We feel they will have the best chance to have a healthy baby by transferring a single embryo, and freezing extra embryos for future pregnancies.

We urge our patients to strongly consider eSET, to have the healthiest pregnancy for your family.