Multiple Pregnancies pose risks to mothers and babies

Women with multiple pregnancies are at increased risk for numerous medical conditions such as gestational diabetes, preeclampsia (high blood pressure), anemia, miscarriage, C-section delivery, hemorrhages (excessive bleeding), and maternal mortality. In addition, their babies are also at increased risk in cases of multiple pregnancies. Women pregnant with twins, triplets, or quadruplets often end up giving birth much earlier than 40 weeks. Preterm labour and delivery may create medical and developmental complications for newborns, such as low birth weight, respiratory problems, and congenital abnormalities. Twins that share one placenta (most often identical or monozygotic twins) may also be at risk for Twin-to-Twin Transfusion Syndrome (unbalanced blood flow from one twin to the other), which can increase the risk of fetal death.

Women seeking fertility treatments are particularly at increased risk for becoming pregnant with multiples. Recent statistics show that approximately 25-35% of children created via in vitro fertilization (IVF) procedures are twins. Since the costs of IVF are high, couples often request that more than one embryo be transferred to the woman’s uterus to increase the chances of a viable pregnancy. In extreme cases (e.g. Octomom), several embryos are transferred at one time, resulting in multiple pregnancies that put both the mother and the children at risk.

Given the significant risks associated with multiple pregnancies (even twin pregnancies), several countries (US, Europe, Australia) have created guidelines in support of reducing the risk of multiple pregnancies when using reproductive technologies and treatments. For example, the Canadian Fertility and Andrology Society has created clinical practice guidelines for IVF, which promote the transfer of only one embryo during IVF, based on the age of the woman. This is referred to as elective Single Embryo Transfer (eSET).

The Canadian Fertility and Andrology Society has stated that the aim of IVF is a healthy, single pregnancy. Read more about this issue here.


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