Twins and Multiple Pregnancy in IVF
In IVF, a multiple pregnancy usually arises when more than one embryo is transferred. Some couples see this as a bonus, but a multiple pregnancy carries added risks for both the mother and the babies.
This article explains how multiple pregnancies occur, the risks involved, and why single embryo transfer has become the preferred approach.
How do twins happen in IVF?
There are two routes. The first is transferring more than one embryo and more than one implanting. The second is a single embryo splitting in early development, which is less common.
In treatments involving ovarian stimulation such as IUI, the development of more than one follicle can also raise the chance of a multiple pregnancy, see our IUI page.
What risks does a multiple pregnancy carry?
Multiple pregnancies need closer monitoring than singletons. The main recognised risks are:
- Preterm birth and the newborn problems that follow from it
- Low birth weight
- Gestational diabetes and pregnancy-related high blood pressure
- Anaemia and greater physical demand in pregnancy
- A higher likelihood of caesarean birth
- Increased risk of bleeding after delivery
For these reasons a multiple pregnancy is not a treatment goal but something to be minimised where possible.
Why single embryo transfer is preferred
As laboratory conditions and embryo selection have improved, transferring one embryo and freezing the rest has become a common approach.
It reduces the risk of a multiple pregnancy while keeping the remaining embryos available for a later cycle, see frozen embryo transfer.
The rules in Turkey
In Turkey the number of embryos that may be transferred is set by regulation. As a general rule, a single embryo is transferred in the first two attempts for patients under 35.
The regulation exists to reduce the risks of multiple pregnancy. Your doctor will explain which rule applies to you based on your age and number of attempts.
If a multiple pregnancy is confirmed
Where a multiple pregnancy is confirmed, monitoring becomes more frequent and the pregnancy is followed more closely, with nutrition, rest and appointments planned accordingly.
You will be advised on the signs of preterm labour, and care at a higher level unit is arranged if it becomes necessary.
Related Reading
Sources and references
This article is supported by the following independent, authoritative sources: