Fertility Treatments and Twins

The Impact of Fertility Treatment Multiple Births

There once was a time when twins were something of a novelty. Now they're a very common part of the scene. Since 1980, the birth rates for twins in the US has jumped 70 percent, with more than three percent of all babies born in the US being part of twins or higher order multiples. The reason for two-thirds of these multiple births is fertility treatments. With more women taking fertility drugs or looking to ART (assisted reproductive technology) to help them conceive, the chances of a multiple birth are very high. The other third of twin births are to mothers who are over the age of 30. Normally the female body releases one egg per cycle every month. However, as a woman gets older, hormonal changes trigger the release of two eggs per cycle. Today about one in 32 births are twins.

We would all agree that twins are adorable. When we see little ones who look alike and are dressed alike, most of us sigh and smile. They're cute. However, the rise in twin births poses a set of complications and risks that most women going into fertility treatments don't hear explained. Doctors do tell them, but the drive to become pregnant is stronger than the willingness to listen. In the US there is now a push to limit the number of embryos used in IVF with the hope of leveling off the numbers - perhaps even reducing them over time.

Fertility Drugs

Fertility drugs are designed to stimulate the ovaries, encouraging them to release several eggs at a time. Women taking gonadotropins, on average, have a 20 percent higher chance of becoming pregnant with more than one baby. Clomid produces a 5 to twelve percent chance of twins. IVF increases the chances to 20 to 40 percent, depending upon how many embryos are placed into the uterus. GIFT (gamete intrafallopian transfer) and ZIFT (zygotes intrafallopian transfer) also increase the chances of multiples. The only fertility treatment at the moment that does not increase the chances of a multiple pregnancy is IUI (intrauterine insemination). With this method, sperm are injected directly into the uterus with a syringe; however, the woman also takes fertility drugs.

Although the number of fraternal twins is much high than identical twins, there is research indicating that the rate of identical twins is rising due to fertility treatments. Fraternal twins are twins that are conceived with two eggs and two separate sperm. Identical twins are a split fertilized egg.

Reducing the Numbers

One thought in terms of reducing the number of pregnancies with twins and multiple pregnancies due to fertility treatments, is to encourage women to have only one embryo transfer in IVF rather than two, as are commonly placed. A single embryo transfer would certainly impact the health care system in the US - and probably in other countries as well. With 60 percent of twins born through fertility treatments arriving prematurely, many of whom do not survive, the impact of multiple births is massive. Twins who are premature and survive often face a lifetime of problems: developmental, cognitive, respiratory, digestive, and trouble with sight and hearing. Twins are also far more likely to have cerebral palsy.

The thing is that doctors, neonatologists, pediatricians and OB/GYNs all know this. The medical community knows - the patients don't know and it is the patients who make the final choice when it comes to crucial decision about fertility treatments. The fact is that in the case of in vitro fertilization, twins are totally avoidable.

Education is Important

Things are not as they were even a decade ago. There are more than 400 fertility clinics across the US and the clinicians working in them have become very skilled at picking the most viable eggs and sperm to combine to produce that precious embryo. This alone makes a huge difference in deciding how many embryos to transfer into the uterus. With the current high success rate of single transfers of embryos, there is no need to continue to implant multiple embryos to achieve pregnancy.

The way the fertility treatment specialists can help to reduce the number of women who become pregnant with twins is to push for education. Most women undergoing IVF have only one thing on their minds - a positive test strip. The risks and ramifications of being pregnant with twins or more is often overlooked and it isn't until there are difficulties with the pregnancy, or the babies are born prematurely, and the costs are overwhelming that the realities of their situations hit home.

Being pregnant with twins has its own set of challenges. Discover more about it through the articles in this section.

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Twins in IVF are NOT "totally avoidable". Even if you have only one embryo implanted there is still the chance of it splitting and resulting in identical twins. The only way of totally avoiding twins is to have one aborted, although the PC term is 'selective reduction' and who is their right mind would do that.
12 years ago