Being Pregnant

One or Two?

Posted by melanieblodgett on September 6th, 2011 at 3:27 pm

5268033950 2b4c577351 e1315336657441 One or Two? I started a discussion last week about twins mostly because I’m fascinated with the rising rates of multiples (which has jumped 70% since 1980, mostly due to fertility treatments) and to bring up the major decision couples who go through IVF have to decide. How many embryos do we transfer?

To those who don’t have to make that decision, the answer might be easy. “Just transfer one, that way there’s no risk of multiples and the pregnancy isn’t as high risk.” But if you think about it from the infertile couple’s perspective, the decision isn’t so clear cut. Not only are they spending a lot of money on the procedure, they’re emotionally involved and so desperate to have a child they’ll go to whatever lengths to make that happen.

I was interested in reading about this exact subject and decision in the article, Taming the Twin Trend From Fertility Treatments from Jennifer Lunden of NPR. I like how Sharon Bernstein, a woman who struggled with infertility and now has twins through IVF, explained her thoughts. “I was so focused on just getting that positive pregnancy test. I really couldn’t think past that event. But as soon as I was pregnant it was like, ‘Now what?’ The risks and the downfalls of a twin pregnancy? No, that was completely a blindside.”

I think any couple who deals with infertility can relate. You’re so focused on the end goal that it’s hard to really weigh the risks that you might choose to take. You just want a baby, dangit! Because doctors are aware of this mentality and the increased risk and cost of multiples, they’re now urging couples to only transfer one embryo. And I was surprised to hear that the success rate is nearly the same. Dr. Robert Stillman explains why:

“Ten years ago, we would hedge the bet. The likelihood of any one embryo implanting and bringing about pregnancy was low enough that you could put two or three or four, and most of the time you didn’t get multiple pregnancies. But now, as the pregnancy rates per embryo have so increased, now you have to put far fewer.”

Ultimately the decision is for you and your spouse to decide with assistance from your doctor. I just wanted to share this information since I know it was helpful for me to educate myself more fully. I doubt the decision is easy for anyone to make and hope that those of you considering IVF right now will find comfort as you make the difficult choice.

For more information, please read the article Taming the Twin Trend From Fertility Treatments.

image: Heather Holinka

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6 Comments

[...] couples undergoing IVF treatment, a emanate arises: how many embryos should we transplant? If you’re one of those people who would adore to have twins, it competence be a elementary [...]

Deciding How Many | fertility news – pregnancy clinic commented on Oct 13 11 at 10:36 pm

This is one more reason for why insurance coverage for IVF should be better – and cover more than one attempt. I know my insurance has a lifetime cap of something like $12K for fertility treatments, or roughly one IVF and maybe one IUI before that. If more than one attempt were covered, this decision would be easier for people. I know if both my tubes had been blocked instead of just the one, I would have been left with IVF as our only option, and my hubby and I would have strongly considered voluntarily going with twins for financial reasons, and to not have to repeat a process that isn’t all that comfortable. I’m fortunate to not have had to make that decision at this point in life (knock on wood), but I think I can empathize with people who do have to make it.
I don’t think anything about IVF is really easy, so if you do end up going that route, I wish you the best of luck, and I hope it all works out well for you. :)

sarahh commented on Sep 06 11 at 4:52 pm

Such a difficult decision which I haven’t had to face yet. This dilemma made me think of a recent NY Times Magazine article (though a very, very different decision) – http://www.nytimes.com/2011/08/14/magazine/the-two-minus-one-pregnancy.html?pagewanted=all

Monica commented on Sep 06 11 at 9:18 pm

Just a small correction: in an IVF cycle, embryos are not “implanted.” They are transferred. That’s the whole crap shoot. You can’t force implantation. If you could, then the success rate would probably be a lot higher. Also, however, the rate of babies with birth defects would probably be higher because it is said that embryos will often fail to implant for the reason that they are not healthy. So, you transfer the embryo(s) in hopes that at least one (and if you’re asking your RE, ONLY one) will implant. When I had IVF, I was ready for the possibility of twins, and I think a lot of infertiltiy patients are, because they’re thinking that they’d love to have two children, but can’t afford to do IVF more than once.

Of course you can’t know what it’s like to carry twins or care for them until you’re there, and I am sure it is HARD. However, while I have heard parents of twins often say that it’s hard, I have never once heard any of them say, “I wish I had only had one. Why did I get saddled with twins? Poor me!” It’s still a huge blessing; one I would have accepted gratefully. Still, I felt outrageously happy with my miracle singleton. If I do IVF again, I’ll get two embryos transferred, just like I did the first time, and for the same reason. I need more chances at success. There is a lot riding on it. What if, during my first cycle, we had transferred only one embryo, and it was the wrong one? The one out of the two we transferred that didn’t make it? I felt more secure transferring two, and I’m glad we did.

Erin commented on Sep 07 11 at 10:14 am

We have friends who struggled with infertility for years before finally getting pregnant with twins via IVF. They were thrilled at the idea of having twins. It has been a big adjustment for them since the babies were born, but welcoming a new baby is ALWAYS an adjustment! Now they have to decide what to do when they’re ready to expand their family again. The husband wants to try the good old fashioned route, but my friend feels like she can’t abandon the rest of her frozen embryos that are waiting in the clinic freezer. But she is terrified they’d end up with triplets this time!!

Melissa commented on Sep 09 11 at 12:11 pm

My friends who successfully got pregnant through IVF all had the same fear of having multiples but said it just isn’t practical when you’re using your life savings to get pregnant.

Two of my really good friends had one baby and can’t afford any more babes. I think it is wrong that insurance companies should decide that for people who could potentially want more children.

Heather commented on Sep 16 11 at 8:40 pm

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