“I’d Really Like to Have Twins”
The Society for Assisted Reproductive Technology (SART) just announced that the number of babies born from IVF and other Assisted Reproductive Technologies surpassed one million with the outcomes reported in the CDC ART report for 2015 (the most recent full year with full outcome data available). Many news outlets also mentioned the statistics for multiple births (twins or greater) that came from these ART cycles – about 20% of all IVF births in the US in 2015.
Of 213,000 IVF cycles undertaken in 2015, just 34% involved Single Embryo Transfer. The remainder of embryo transfers utilized 2 or more embryos.
I often hear or read comments from IVF patients about how “fun” it would be to have twins, or that after all of the expense they’ve gone to, it would be nice to get a “BOGO” (Buy-One-Get-One) baby. I really do understand the sentiment – given all they have been through. And I get a significant amount of resistance at times when I encourage my IVF patients to strongly consider Elective Single Embryo Transfer – eSET.
So why do I encourage eSET? Here are the reasons in a nutshell:
1. There are health risks to mother and babies in any multiple birth – even twins. Some of the most notable risks include:
- Premature Labor – According to the March of Dimes, 60% of twin pregnancies and more than 90% of triplet pregnancies are delivered prematurely, which can contribute to potential medical complications during birth as well as ongoing health issues. In addition, twins almost always require C-Section deliveries, making recovery time and potential complications greater for the mother.
- Low Birth Weight – This can contribute to short and long term health risks.
- Preeclampsia – This is a condition that affects the mother and is marked by high blood pressure, severe headaches and swelling in the feet, legs and hands.
- Intrauterine Growth Restriction (IUGR) – A fetus that is at or below the 10th percentile or its gestational age is considered to have IUGR. This is more common in multiple gestations and can lead to premature delivery, hypoxia, hypoglycemia and increased risk of motor and neurological disabilities.
- Hypertension (High Blood Pressure) in the Mother
- Gestational Diabetes in the Mother
- Fetal Loss – Probably the most heartbreaking risk of multiple gestations.
2. Success rates have increased substantially over the past 5 years, making it nearly as likely to achieve a successful pregnancy with a single embryo as with two or more embryos. At Caperton Fertility Institute, our rate of positive pregnancy tests across all ages are high with elective Single Embryo Transfer..
3. Cryopreservation (freezing) technology has advanced to the point where there is virtually no risk to freezing embryos after they have been cultured in the lab to the blastocyst stage. The successful thaw rate is nearly 100% in viable embryos. Because the majority of the cost of an IVF cycle is front loaded in the stimulation, egg retrieval and embryo culture, the incremental cost of additional frozen embryo transfers is relatively low.
4. Embryo culture and laboratory technology are advancing rapidly, giving embryologists many more tools and techniques for providing the best environment for embryos to grow, as well as methods for identifying those embryos that are most likely to make a baby. This contributes to the likelihood of success on the first embryo transfer as well as subsequent transfers.
Our mission at Caperton Fertility is building happy and healthy families. That is how we truly measure success. The statistics don’t show the human side of fertility care. So though it may decrease our percentages by a few points, this is more than compensated for by the satisfaction and peace we feel knowing that we are doing what will bring our patients the greatest long term health and happiness.x
Having experienced several complicated and high-risk pregnancies of our own, Kelly and I are intimately familiar with the stress and heartache of narrowly missing a tragic outcome. This is what drives us in our approach and philosophy of a single embryo for a single healthy baby.