Answer from: Raúl Olivares, MD
Yes, you can ask for whatever you want when you do an IVF, but another thing is if we do recommend having twins. It’s true that sometimes for the patients, it is a good deal if you just go through one IVF, and you have your two babies, and you can close this door and start a different life forgetting about the fertility issues. However, as I like to say, what we are looking for is not the eggs, we are not looking for the embryos, we are looking for healthy babies.
The easiest way of having a healthy baby is having a single pregnancy. Though sometimes twins may look like a good option, and it’s true that in some cases 2 is better than 0, you need to keep in mind that twin pregnancies are not completely free of risks, which include preterm labour, higher risk of developing preeclampsia or hypertension or gestational diabetes, one of the babies could grow well, and the other has problems, and then you may have to make a tough decision because what is going to be good for one of the babies is not going to be good for the other.
Unfortunately, every so often, we have patients having their babies at 29 or 30 weeks. Such babies weigh 900 grams and are not free of having severe complications. Another important aspect to consider when you request transferring more than 1 embryo is that the embryos when transferred together, don’t disturb, nor help each other. They are completely independent beings in the sense that if we transfer 2 embryos, and you get twins – if these embryos have been transferred in 2 different cycles, you probably got two different pregnancies.
When you transfer more than one embryo, you may be saving time because you are going to need fewer transfers, you may be saving money as well. But, each transfer has a cost. You are not going to increase the overall pregnancy rate of the cycle. If you do an IVF and you end up with 4 embryos, these embryos could offer you, let’s say, an 85% success rate with any of them, not the first. The first, probably the second, or the third one. That 85% is going to be exactly the same. It doesn’t matter if you transfer 1 embryo four times or if you transfer 2 embryos twice. You are going to need fewer treatments to reach that 85%, but the overall pregnancy rate of the cycle is not going to change.
From the medical point of view in terms of success rate and babies’ safety – there is no medical reason to transfer more than one embryo together. The only reasons are related to time or money.
Answer from: Harry Karpouzis, MD, MRCOG, DIUE
No, actually, you cannot ask for twins. You can say that you’re not going to have a problem with twins. Then, with your doctor and depending on what exactly is happening in your IVF and your medical history, we’re going to decide if we transfer one or two embryos. If we transfer one embryo, the chances of identical twins are very rare. If we transfer two embryos, there are chances of twins, which depend on your age, if IVF is with your own eggs, donor eggs, those chances can reach up to 25%. The answer to this question is if you don’t want twins, you can go ahead with 1 embryo.
Transferring 2 or sometimes 3 embryos in older women especially, if the embryo quality is not good, can increase the chances of success. Though you need to keep in mind that you might have twins. Twins cannot be guaranteed from one embryo transfer because implantation can never be guaranteed in IVF.
Answer from: Kristine Kempe, MD
Multiple pregnancies are more complicated. This complication can impact both the mother and the fetus. For the mother, it can be the same complication as in a singleton pregnancy. However, those complications can be more serious, like preeclampsia, blood pressure problems, polyhydramnios, etc. Sometimes there are some delivery complications or post-partum bleeding. Regarding the babies, there is an increased risk of congenital anomalies such as cardiac defects, bowel atresia, or twin to twin transfusion syndrome.
How can we expect twins after IVF? Is it something we can influence?
It is always quite a big discussion whether it is possible to ask for twins when undergoing IVF treatment? Is there a higher chance of having twins after IVF treatment? If so, are there any risks of having twins through IVF? Why doctors usually don’t recommend multiple pregnancies?