IVF And Multiple Pregnancies – Busting Myths Around It

One common misconception surrounding IVF is the assumption that it inevitably leads to twin or multiple pregnancies.

When conceiving naturally, the occurrence of multiple pregnancies (twins or triplets) in the general population is about two percent. This means that out of every hundred pregnancies, one or two may result in multiple pregnancies. However, during IVF treatment, doctors aim to enhance the chances of pregnancy. Consequently, with IVF, the likelihood of multiple pregnancies increases by approximately 20 to 30 percent. In other words, out of every hundred pregnancies resulting from IVF, around 20 to 30 may involve multiple pregnancies.

During an IVF treatment cycle, a woman receives injections to stimulate the development of an increased number of eggs. These eggs are then retrieved from the body and fertilized with the male’s sperm. Once fertilization occurs, an embryo is formed. These embryos are cultured in a laboratory for a period of three to five days. Subsequently, the embryos are transferred back into the uterus through a procedure known as embryo transfer.

Embryo transfer can be performed in two ways: single embryo transfer or double embryo transfer (transferring two embryos). The decision to opt for a single or double embryo transfer depends on various factors and is determined through discussions with the doctors. Double embryo transfer is typically chosen to increase the chances of pregnancy and can result in a twin pregnancy in approximately 35 to 45 percent of cases. However, this approach is only carried out with the explicit consent of both the partners.

In the case of a double embryo transfer or when two embryos are transferred, three possible outcomes can occur. Firstly, both embryos may successfully implant into the uterine lining, leading to a twin pregnancy. Secondly, only one of the embryos may implant and grow, resulting in a single pregnancy. Lastly, neither of the embryos may successfully implant, resulting in no pregnancy. The success of implantation depends on factors such as the quality of the embryos, the receptiveness of the uterine lining, and various patient-specific factors.

Debunking Misconceptions: IVF and Multiple Pregnancies

One common misconception surrounding IVF is the assumption that it inevitably leads to twin or multiple pregnancies. However, the reality is more nuanced, and there are various factors at play that determine whether a twin pregnancy will occur. Understanding these factors can help dispel misconceptions and provide a clearer perspective on the possibilities of IVF outcomes.

Tailored Approach: Single vs. Double Embryo Transfer

Contrary to popular belief, not all IVF patients undergo a double embryo transfer. The decision to transfer one or two embryos depends on several considerations. For instance, individuals with a smaller uterus or certain medical conditions that make carrying a twin pregnancy challenging, such as cardiac diseases, may opt for a single embryo transfer. This personalized approach ensures the best possible outcome for each patient’s unique circumstances.

Patient Preference and Rare Occurrences

It’s important to note that patient preference also plays a role in the decision-making process. If a patient specifically requests a single embryo transfer, doctors take this into account after thorough discussions. However, even with a single embryo transfer, there is an exceedingly rare chance (around 1%) that the implanted embryo may spontaneously split, resulting in identical twins. In contrast, transferring two embryos increases the likelihood of non-identical or fraternal twins.

Clarifying Misconceptions

Addressing these misconceptions is vital to provide accurate information about IVF and multiple pregnancies. While IVF treatments do offer higher chances of multiple pregnancies compared to natural conception, it is not a guarantee. Each case is unique, and decisions regarding embryo transfer are made based on factors such as medical considerations, patient preferences, and the potential for a healthy pregnancy.

Misconceptions about IVF treatment often lead patients to specifically request twins. However, the occurrence of twins is not guaranteed, even with a double embryo transfer. Each case is unique, and the decision for double embryo transfer depends on individual circumstances.

Risks and Challenges of Multiple Pregnancies Resulting from IVF

Twin pregnancies, stemming from IVF, pose specific risks and challenges due to the limited space within the uterus because they are designed for single pregnancies. Unlike animals such as cats or dogs that naturally give birth to multiple offspring, humans are built to carry and deliver one child at a time. The confined space can lead to preterm delivery as the growing babies prompt contractions and premature rupture of membranes, compared to natural pregnancies.

Consequently, twins often have lower birth weights than singleton pregnancies. Moreover, there is an increased likelihood of maternal complications in twin pregnancies. Preeclampsia, characterized by high blood pressure or hypertension during pregnancy, becomes more prevalent. There is also a higher risk of developing gestational diabetes and anemia, indicated by low hemoglobin levels. Due to these concerns, close monitoring becomes crucial to ensure the well-being of both the mother and the babies.

In summary, the limited uterine space in twin pregnancies resulting from IVF can lead to preterm delivery and lower birth weights. Additionally, the mother faces an elevated risk of preeclampsia, gestational diabetes, and anemia. Vigilant monitoring is essential to assess the health of both the mother and the babies throughout the pregnancy

Tips for Managing Multiple Pregnancies

Prioritize preconception health with a thorough check-up to address existing conditions.
During pregnancy, undergo regular check-ups for monitoring and early detection of complications.
Watch for warning signs like leg swelling that may indicate preeclampsia. Similarly, for anemia, watch out for warning signs such as fatigue and giddiness.
Discuss with your chosen IVF institution about the probability of twin success rates before you decide on a double embryo transfer

By following these tips and openly communicating with your doctor, you can navigate the challenges of multiple pregnancies more effectively, ensuring the best outcomes for both mother and babies.

The article is written by Dr Nikitha Murthy B. S, Fertility specialist at Garbhagudi IVF.