Multiple pregnancies are those in which more than one fetus develops during gestation. Twin pregnancies comprise the most common cases, although multiple pregnancies on the whole are on the rise, including triplets and quadruplets. This increase is due to the advancement and growing popularity of assisted reproductive therapy. As infertility treatments become more advanced and more widely available, the numbers of multiple births increase accordingly.
In-vitro fertilization is a reproductive technique where the egg and sperm are fertilized under a controlled laboratory setting and allowed to develop into embryos, which are then reinserted into the uterus. Usually two or three embryos are used in order to increase the chance of a viable pregnancy. When more than one embryo achieves implantation, the woman—now and expectant mother is usually faced with the decision on what to do about the “extra” baby that they will carry. Multiple embryos increases the chance of multiple births greatly. In one study shows IVF babies are 20 times more likely to be multiple birth babies than babies not conceived through IVF.
The risks for pregnancy-related complications are increased for women carrying multiple fetuses. These complications include preterm labor, gestational diabetes, preeclampsia, hemorrhage and developmental problems in the fetus.
Preterm labor is the most common complication associated with multiple births. Gestation period for single pregnancies is considered normal if it falls between 37 and 42 weeks in duration. Twin pregnancies are more likely to fall short of 37 weeks. Premature babies are at risk of more health problems than babies born after a full gestation period. They have underdeveloped immune systems, respiratory systems, among other problems. Because of this, preterm babies must spend time in neonatal intensive care units (NICU) for monitoring, treatment and to allow for them to develop further before they can be brought home.
Developmental delays as well as cerebral palsy have a higher incidence in multiple pregnancies. Due to these increased risks, many fertility specialists recommend that couples seek counseling before starting any fertility treatment.
For many couples struggling with infertility, the thought of having twins or triplets from a single pregnancy sounds very encouraging. They often feel that since IVF treatment is so unpleasant and expensive, multiple pregnancies are justified. On the contrary, these couples may be ignoring some very serious risks to the mother and fetus.
After finding out that it’s a multiple pregnancy, the excitement fades quickly, and there are important psychological and economic issues must be considered. Once a multiple pregnancy has occurred there is little that can be done. Reducing an embryo is a highly risky procedure that can put both fetuses at risk. This procedure involves injecting drugs into the undesired fetus, essentially an induced abortion. This highly controversial issue highlights the moral challenges of fertility treatments.
Multiple pregnancies are among the many serious side effects of IVF treatments. It is important that couples undergoing assisted reproductive therapies understand the implications before they even start treatment.