Doctors from the University of Montreal, Canada, say that if only single embryos were transferred to women undergoing IVF it could save up to 40 lives a year and prevent cases of blindness and brain damage.
This is because one in four IVF pregnancies are multiple pregnancies, compared with only one in 80 naturally conceived pregnancies.
Risks of Multiple Pregnancy
Multiple gestation carries many more risks than singleton pregnancy, including increased risk of miscarriage, high blood pressure, pre-eclampsia and placental problems. If the twins are identical they also have a risk of twin to twin transfusion syndrome (TTTS), where some blood from the placenta passes from one twin to the other. If one twin gets more blood than the other, it puts him at risk of heart failure and his twin at risk of malnutrition.
Due to all these reasons, premature birth is much more common for twins and this brings with it the heightened risk of death or life-long disability.
Other complications of being born prematurely include immature lungs resulting in respiratory distress syndrome, lung injuries due to being on a ventilator, apnea (pauses in breathing), opportunistic infections due to an immature immune system, such as pneumonia and sepsis (bacteria entering the blood stream).
Risks to the Mother
If the mother-to-be has high blood pressure this can lead to a stroke or heart problems. Pre-eclampsia can lead to seizures and in some cases, death. Around 50% of all twins are now delivered by caesarean section. All triplets and higher multiples are delivered surgically. Caesarean sections are riskier to mothers and the maternal death rate resulting from them is three times higher than vaginal birth (one in 10,000 for vaginal birth and 4 in 10,000 for caesarean section).
17% of NICU Babies are IVF Multiples
Researchers looked at a database of hospital records and compared complications associated with single embryo transfer and two embryo transfer and found that 17% of their neonatal intensive care admissions were babies from multiple gestations resulting from IVF. This is a big increase in the number of cases over the last decade.
Single Embryo Transfer Could Reduce NICU Stays
By reducing the likelihood of multiple pregnancy by only transferring one embryo to the woman, the researchers say it could reduce NICU patient days by 3082 days and a further 270 days that babies spend on a ventilator. Single embryo transfer could also prevent 34 to 46 severe intracranial haemorrhages (bleeds in the brain) and 13 to 19 retinal (eye) surgeries every year.
The study authors concluded:
‘A mandatory policy of single embryo transfer would be of substantial benefit to the health of Canadian babies while still benefiting infertile couples.’
Sources:
- The Epidemic of Multiple Gestations and Neonatal Intensive Care Unit Use: The Cost of Irresponsibility, April 2011, The Journal of Pediatrics.
- Multiple births and single embryo transfer review, Human Fertilisation and Embryology Authority.
- Enkin, M., Keirse, M.J.N.C., Neilson, J., Crowther, C., Duley, L., Hodnett, E. and Hofmeyr, J. (2000) A guide to effective care in pregnancy and childbirth Oxford University Press, 3rd Edition.
Joanna Karpasea-Jones - I have been a health writer since 1997 when I published my own newsletter, SHOTS. I have written 2 books on childhood health, and write ...
