What is embryo reduction? When should it be done?

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1 fertility expert(s) answered this question

Answer from: Aleksandr Darii, PhD

Gynaecologist, Leading Fertility Specialist at ICSI Clinic ICSI Clinic
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Today I’m going to talk about embryo reduction. Embryo reduction is a clinical interruption of the heartbeat of one of the fetuses in other to allow the other fetus who is close to the uterus to develop normally without risk and without complications till delivery.

The reduction can be done in multiple pregnancies, with 3-4 fetuses, two single pregnancies, or twins. In this case, the reduction procedure is carried out around the time of 9-10 weeks of pregnancy. At that time, it can already be seen how each of the fetuses develops. We can observe their evolution, their location and estimate the size of each of them and their heartbeat. In a few hours, we can get the chorionic villus sampling result and the chromosome set of each of the fetuses – this allows us to find out which of the fetuses is healthy and which is not. Also, the sex of the embryo can be revealed for those patients who need it.

Based on all this and all clinical ultrasound data on the development of the pregnancy, we make the decision which of the fetuses to reduce and which to leave. We make this decision with the patient. Everything is done in our clinic without risk, without complications. How is it done in our clinic? As far as I know, clinics nowhere in Ukraine nor in the world do it. But, here at ICSI, you can get chorionic villus sampling results in a few hours’ time without risk or complications. We have had this established practice for many years and our services are used by pregnant women not only from our clinic. We accept everybody who has decided to undergo the embryo reduction procedure from all over Ukraine, no matter if it’s a natural pregnancy or an IVF one. If the patient wants to reduce from triplets to twins, from twins to a single pregnancy, we can offer this.

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What are the medical benefits of multifetal pregnancy reduction?

About 8 to 20% of multiple pregnancies may reduce by themselves by the end of the first trimester. This is usually due to the presence of aneuploidy embryo(s). Although not all multifetal pregnancies occur after the use of IVF treatment, IVF has contributed greatly to the increase in multiple pregnancies. Higher-order multifetal pregnancy always poses a risk to the mother and the babies. Most fertility experts, in almost all cases, recommend avoiding the risk of such pregnancy by transferring a single embryo. However, if a multifetal pregnancy has already occurred, a surgery called embryo reduction can be carried out to lower the number of fetuses and improve the patient’s chances for a healthy pregnancy. It’s a safe procedure, and the chances of complications are small.

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