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Multiple pregnancies and IVF

Pregnant woman looking at photosThe multiple birth problem

One of the biggest risks of fertility treatments with assisted reproduction techniques is the multiple pregnancy. This happens because very often more than one embryo is transferred into the uterus to rise the chance of pregnancy. Although some couples that struggle with infertility wouldn’t mind having twins or triplets, the multiple pregnancies increase the risk of disabilities, stillbirth and neonatal death in the children to be born. Furthermore risks of serious complications concerning the mother also increase. Those complications include miscarriage, pre-eclampsia (a pregnancy disorder which might become more serious with time) and high blood pressure.
In natural pregnancies on average 1 women in 80 will have a multiple pregnancy, while using IVF changes this numbers to 1 in 5! Considering how many IVF babies are being born each year multiple pregnancies have become a serious public health concern. You will find more details about those risks concerning both mothers and the babies below.

Baby risks

Babies born from multiple pregnancies are exposed to health risks because often they are born prematurely and can be underweight. The risk of late miscarriage is also increased with twins and triplets. Most of the babies born in a multiple pregnancy are identical babies which share a placenta, those babies are at higher risks of health complications than non-identical.
In some cases the multiple pregnancy is such a serious risk to the health of the mother that the clinician could suggest a fetal reduction which means the removal of one or more of the foetuses.
One of the risks of multiple birth is the premature birth. About half of the twin births come before 37 weeks of pregnancy. The babies born at that time are of low weight which could have serious health consequences or even death. More than 90% of triplets get born before 37 weeks or even earlier which often has long-lasting effects on their health and can also cause death not long after the birth.

Problems caused by premature birth in the early stages:

  • 40 to 60% of the IVF twins need intensive care immediately after birth.
  • 8% of IVF twins need help with their breathing
  • 6% suffer from respiratory distress syndrome
  • IVF twins have a higher risk of death in the first year of life than single babies
  • IVF twins have a 3 to 6 time higher risk of dying at birth, 9 times higher if they are triplets

Long term problems with premature birth:

  • Some IVF twins will have serious health problems all their lives. They could suffer from cerebral palsy.
  • Low weight at birth can cause lower IQ and behavioral difficulties
  • Problems with speech development

Mother risks

Risks of serious health problems are higher during multiple pregnancies.

  • Risks during the multiple pregnancy include:
  • Early or late miscarriage
  • Induced hypertension which causes high arterial blood pressure is 20% more likely to occur when carrying twins
  • 30% chance that the multiple pregnancy will cause pre-eclampsia
  • Gestational diabetes is 12% more likely to occur than in a single pregnancy

Some statistics

  • 1915 to 1980 – about 1 in 50 babies were twins, a 2 % rate
  • 1995 to 2001 – rate rises from 2,5% to 3,3% and 1 in 30 babies were twins
  • Twin birth rate in 2012 was 33.1 per 1,000 total births, and was essentially unchanged from 2009-2011
  • 1009,337 extra twins were born since from 1980 to 2012
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