Doctors report “epidemic” of fertility twins

Doctors are reporting an epidemic — of twins. Nearly half of all babies born with advanced fertility help are multiple births, new federal numbers show.

In the five years since the “Octomom” case, big multiple births have gone way down, but the twin rate has barely budged. Twins have much higher risks of prematurity and serious health problems.

The Centers for Disease Control and Prevention’s most recent numbers show that 46% of IVF babies are multiples — mostly twins — and 37% are born premature. By comparison, only 3% of babies born without fertility help are twins and about 12% are preterm.

It’s mostly an American problem. Some European countries that pay for fertility treatments require using one embryo at a time.

The American Society for Reproductive Medicine is trying to make it the norm in the United States, too. Its guidelines, updated this year, say that for women with reasonable medical odds of success, those under 35 should be offered single embryo transfer and no more than two at a time. The number rises with age, to two or three embryos for women up to 40, since older women have more trouble conceiving.

To add heft to the advice, the guidelines say women should be counseled on the risks of multiple births and embryo transfers and that this discussion should be noted in their medical records.

Taking these steps with single embryos results in fewer miscarriages and tubal pregnancies, healthier babies with fewer genetic defects and lower hospital bills from birth complications, many fertility specialists say.

Studies back this up. In May, doctors randomly assigned 175 women to have either a single embryo transferred after chromosome screening or two embryos with no screening, as is done in most IVF attempts now. Delivery rates were roughly equivalent — 61% with single embryos and 65% with doubles.

At RPMG we have been encouraging the transfer of fewer embryos for some time to achieve the goal of fewer twin pregnancies. In Fact we initiated an Elective Single Embryo (eSET) Encouragement Program to encourage younger couples with good embryo quality to agree to a single embryo transfer.

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