Archives for September 2013

The Truth About IVF & Multiples

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About a month ago now, an anonymous father shared his disappointment and unhappiness at the upcoming birth of his twins via IVF on his Babble.com blog post for the world to see. See the CNN article here. He explained that he and his wife were “pissed. And terrified, and angry, and guilty, and regretful.” To say that they were upset at the prospect of having two healthy babies is an understatement. One commentator wrote, “…there are thousands of parents out there who would love to take them in. I’m not sure if I should feel [pity] or disgust.” Yet others sympathized with him at the hardship that raising twins will bring but nevertheless emphasizing the blessing it is in the end.

It is important to note that while IVF increases the chance of multiples, it is not as likely as one might believe. Today, increased success rates allow for the implantation of fewer embryos, which therefore result in less multiple births. However, like many of those who showed their support for the Babble Blogger parents, there is a misconception that persons using IVF will likely get pregnant with an unusually high number of children. Just last week I was at the beauty salon and two of the nail technicians were talking about how “dangerous” IVF was because you could get pregnant with EIGHT children. This idea has stuck in people’s minds due to the media coverage and popularization of people like Nadya Suleman (“Octomom”) and shows like John & Kate Plus Eight on TLC.

The truth is that although IVF has an increased chance of multiples, recent technology and practice limits it primarily to singletons or twins. Earlier this year, The Society for Assisted Reproductive Technology [SART] released it’s latest data which confirms that the number of live births resulting from IVF are going up, while the chances of having multiples is consistently going down.  SART’s national statistics show that for women between the ages of 35 and 37 undergoing IVF and using fresh embryos, 26.7% of them had live births resulting in twins, while only 1.3% of them had live births resulting in triplets or more. Those numbers go down to 14.9% and .7% for women ages 41 to 42 and with on-going medicals trials improving the success rates, the numbers continue to decrease. See Fertility and Sterility 100.3 (2013): 697-703 abstract here.

These same outcomes are reflected internationally as well. The European Society of Human Reproduction and Embryology reports that in 2010 the average number of embryos transferred per cycle was 1.75. Furthermore, a more recent trend is to only implant one embryo per transfer, this technique is referred to as a single embryo transfer or SET for short. The use of SETs is reflected in Europe’s low rates of multiple births. For example, Sweden has the lowest multiple delivery rates in the world right now and 73.3% of all transfers performed there were single embryo transfers. Due to higher success rates, this is a trend that is picking up speed in the United States as well.

Ultimately, just like a natural method of conceiving, it is hard to know for sure how many embryos will take before they actually do, but technology today gives us a really good idea. When you begin your journey, you and your doctor should have gone through all of the possible outcomes and make sure you are fully informed before making your decision. In the end, with the information available to you and the informed consent from your physician, the possibility of multiples should never be a complete surprise. Keep in mind however, that with single embryo transfers becoming more of the norm and technology advancing more and more everyday, that possibility is lower than you might expect.