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Lowering the Risk of Multiple Pregnancies

How we’re lowering the risk of multiple pregnancies

It is not unusual for a couple struggling to become pregnant to hope for twins. This is especially true if the couple has not had children. It is important to realize that it is safer for the mother and her baby to have a singleton pregnancy. That’s why we work to work the risk of multiple pregnancies.

The risk of multiple pregnancies

Most patients appreciate that pregnancies are more complicated when a woman is carrying triplets, quadruplets or even more. However, they commonly do not appreciate that a twin pregnancy can be significantly more risky than a singleton pregnancy. Risks to the mothers include an increase in miscarriage (2X), hyperemesis (morning sickness), pregnancy-induced hypertension (3X), preeclampsia, gestational diabetes, acute polyhydramnios (excessive amount of amniotic fluid), vaginal and/or uterine bleeding and hemorrhage (uncontrolled bleeding), preterm labor and delivery, prolonged hospitalization and surgical delivery (Cesarean section).

Also, a twin pregnancy is more risky for babies. The complications of the mother from carrying multiples can create complications for the babies. The maternal problems commonly result in babies being premature. Pregnant women with one baby tend to carry the pregnancy to 40 weeks. However, pregnant women two babies rarely go beyond 38 weeks. Consequently, infants born from a multiple pregnancy have a greater risk of infant mortality (4-5 times higher for twins than for a singleton pregnancy). They also have a greater risk of mental and physical problems that can result from a premature delivery.

Unfortunately, to increase the chance of becoming pregnant with a fertility treatment, there is a risk of a multiple pregnancy. When utilizing in vitro fertilization, there is an opportunity to minimize this risk by limiting the number of embryos being transferred back to the woman. Our national organization, American Society of Reproductive Medicine, (ASRM) has published guidelines for the number of embryos to transfer according to the age of the woman to minimize triplets and to lower the number of twins. Not too many years ago, IVF programs averaged a triplet rate of 4-8%. The goal is to have a triplet rate of <2%.

How to lower the risk

In a spirit of trying of eliminating triplets and significantly reduce the rate of twins, our group developed criteria to help guide couples in deciding to transfer only one embryo. As laboratory procedures become more refined, many more patients can benefit by transferring only one embryo without compromising their chance of becoming pregnant.

It is incumbent on physicians to minimize multiples when assisting couples with conceiving. Although each couple may have different fertility problems, different expectations, and different chances for success with the fertility treatments, the ultimate goal is have a safe pregnancy. Don’t hesitate to discuss ways to minimize your risk of having a multiple pregnancy with your physician. Contact us to learn more.

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