Risk of Multiples with Fertility Treatment

On May 11, 2017, a couple in Virginia welcomed sextuplets after trying to conceive for 17 years.  This story made headlines in every major news outlet not only because of the number of babies born at one time, but also because of how long the couple had been trying to conceive.  While it’s definitely a happy occasion that this couple finally became parents, we shouldn’t forget that having a multiple gestation pregnancy comes with many complications for mother and babies.

Each of these babies weighed between 1 pound, 10 ounces and 2 pounds, 15 ounces.  They were born significantly preterm and each had a long stay in the neonatal intensive care unit.  Undoubtedly, these children were conceived through the use of fertility treatment.  Based on the news stories, it’s difficult to tell if they were conceived via IVF or the use of fertility medications with intrauterine insemination.  Either way, most fertility experts would agree that the treatment was too aggressive.  The goal of fertility treatment should really only be to conceive 1 healthy baby at a time.

There have only been 24 quintuplets or other higher order births since 2o15, but the rate of twins and triplets has increased dramatically over the last few decades.  The twin birth rate in the U.S. has increased by more than 75% since 1980.  Today, almost 4 in 10 children born through IVF are twins.  Although twins have become so common, these pregnancies also have higher risks, including risks of cesarean section, gestational diabetes, preterm birth, hypertensive disorders in pregnancy, etc.

The American Society of Reproductive Medicine (ASRM) has set forth guidelines for the number of embryos to transfer with in vitro fertilization to minimize these exact risks.  The guidelines are meant to give women a high chance of pregnancy, but minimize the risk of multiples.  These are just recommendations though.  Fertility centers don’t have to follow them.  In fact, many centers choose not follow the guidelines, likely in an effort to improve their published success rates.  The more embryos they transfer, the more pregnancies they can report, which will bring more patients to their centers.

At Reproductive Partners, we have one of lowest multiple pregnancies rates in California. We do our best to adhere to ASRM guidelines to keep our patients and their future children safe and healthy.  Of course, there will always be occasions to deviate from the guidelines, but we pride ourselves in extensively counseling our patients about the risks and benefits of multiple embryo transfers.  We make the decision together with our patients.  Our goal isn’t to boost our success rates.  It’s to make happy and healthy families.