IVF twins – twice as nice ? or double the trouble ?

Many IVF patients dream of having twins.

Twins look cute – especially in movies ! Everyone thinks they are adorable, and how much fun it would be to dress them up in identical clothes.

Also, having twins is getting an instant family. It’s a bonus – pay for one, and get one free !

You never need to do another IVF treatment again, so it seems to be great value for money as well !

This is why many couples ask us to transfer 2 – or even 3 or 4 embryos at one time. They believe this will increase their chances of success – and they are quite happy to have twins. In fact, many IVF specialists encourage this too – and there are many celebs who happily pose with the IVF specialist with their twins – and even their triplets – in tow.

However,  the truth is that multiple pregnancies – even twins – is actually a complication of IVF – not a desirable outcome.

For one thing, transferring 2 embryos at a time does not increase your overall chances of success. This seems counterintuitive – after all, won’t putting more embryos back improve success rates.

Let me explain.

Don't compare apples and oranges please. You can’t compare the chances of success with transferring one embryo at one time versus two embryos at one time, because obviously the chances will increase if you put two at a time. 

However, remember that if you put two at a time, and you don't get pregnant then you have lost both the embryos, whereas if you put one, and the cycle fails, you still have one more to transfer in the next cycle. 

This is why the cumulative ( additive, sum or total) pregnancy rate with transferring one embryo at a time is actually far better ! It allows you to have your cake and eat it too .

 Also, it is much safer to transfer just one embryo at a time. The risk of preterm delivery and premature births - and therefore neonatal complications - is much higher for a twin pregnancy. Not only is neonatal intensive care very expensive ( if you think IVF is expensive, you will get a heart attack when you see NICU bills – and you have to pay for each baby !), the risk of the baby having long-term health problems ( such as cerebral palsy) are much higher as well. Please ask a pediatrician, and he will corroborate what I am saying.

This is why we tell our patients – have as many babies as you like – but one at a time. This is in line with global best practices, so don’t try taking shortcuts which you will regret later on for the rest of your life.