Under in-vitro fertilization (IVF) procedure, the eggs and sperm of the couples with infertility issues, are made to fertilize in laboratory conditions, in contrast to artificial insemination, where conception occurs within the uterus after insertion of sperm. The formed embryos are planted into the uterus of female partner under IVF.
Usually more than single embryo is used for fertilization with sperm to increase viable chances of pregnancy. As a result, multiple embryos form, increasing the chances of multiple births in IVF pregnancy. The latest reports have shown that IVF babies have 20 times more chances of being multiple birth babies than normal pregnancy babies.
Twins babies have been the common outcome of multiple pregnancies but lately, there have been tremendous rise in triplets and quadruplets babies with IVF technique. The increased probability is due to high success rate of IVF than before, and easy access to rapidly growing IVF centers.
Risks Involved with Multiple Pregnancies
Multiple birth risks (MBR) refers to probability of conceiving a number of fetuses through single pregnancy, due to IVF technique. Normally, chances of carrying identical twins through natural pregnancy are 1 in 250 and that of fraternal twins are 1 in 60, but with an advancement of IVF technique and fertility drugs, MBR has increased substantially in the population.
Woman with IVF pregnancy stands 10 times higher chance of giving birth to twins or triplets. With IVF, chances of having twins have risen to 20-25% due to transfer of large number of embryos in a single IVF cycle.
Pregnancy Related Complications
The risks of complications linked to pregnancy increases manifolds and the pregnant women get prone to preeclampsia, gestational diabetes, hemorrhage, fetal growth abnormalities and preterm labor, giving rise to premature babies.
Delay in achieving development milestones could be observed in children, born through multiple births. The progress of skills in areas of cognition, fine and gross motor skills, language, emotional and social maturation gets usually delayed due to preterm birth. The child could also possess some disorders linked to mental health. Hence, couples with infertility issues must undergo counseling, before opting for fertility treatment solutions.
The major problem observed in multiple births is the reduction in gestation period from an average 40 weeks in single pregnancies, to 35 – 37 weeks in multiple birth pregnancies, giving birth to premature babies. Premature babies are at increased risks for various health problems than babies born after full term gestation period.
The complete development of fetus gets completed by 36 weeks only and any birth before that result in incomplete physical and mental development, in babies. Therefore, preterm babies are meant to be put in intensive care units, specialized for neonatal care for monitoring baby’s development and manifesting treatment for undeveloped organs and systems.
Measures to Lower Risks of Multiple Births through IVF
As soon as it is known that there exist an infertility issue, seek advice from fertility specialist, without delay. The risk of IVF linked multiple births is very much linked to maternal age of the woman in question. Younger women have higher chances of conceiving with single embryo and reduce risk of multiple births in single pregnancy. Risk of multiple birth increases for women exceeding 30 years of age and is linked to state of her healthy well being.
Single Embryo Transfer
Single embryo transfer could be employed, where only one potential, high quality embryo is selected from in-vitro fertilization and implanted into the uterus, giving rise to only one fetus during the pregnancy. Single embryo transfers have success rates as high as that observed in multiple embryo transfer without risk of multiple pregnancy complications.
Women may need to go under number of IVF cycles in order to achieve the most potential embryo, for a safe and successful pregnancy. It is most favorable to women below 35 years of age, but could also be employed for women beyond 35 with good health and without any medical issues. Let the gynecologist and IVF specialist take the final call on whether women could opt for that option.
Single Blastocyst Transfer
For blastocyst transfer, the embryo is allowed to mature in-vitro till blastocyst stage, and then one of the best quality blastocyst is chosen for implantation into the uterus. This technique is known to be suited for women above the age of 35 years, willing to have a single child. The only consideration is having high quality eggs, which usually goes down as women age. The technique is successful depending upon individual diagnosis and circumstances.
Comparative Genomic Hybridization (CGH)
The new form of screening technique, where the IVF specialist aims to choose the best quality embryo for IVF implantation, is known as comparative genomic hybridization. CGH biopsy is performed on day 5 from outer layer of matured blastocyst, without causing any damage to the embryo. CGH helps to screen genetic abnormalities over entire chromosomes of human genome, which inturn aids to improve IVF success rate by involving less number of embryo transfers per IVF cycle.