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Tuesday, December 3rd, 2013
With IVF treatments, twins have basically become the new norm—46 percent of IVF births are multiples, mostly twins. But now fertility experts want to change that. The new goal: single births, even when using IVF. Why? Twins have a much higher risk of being preemies and having serious health problems that could potentially last a lifetime.
The most recent info from the Center for Disease Control and Prevention states that 37 percent of IVF babies, who are multiples, are born premature, while only 3 percent of babies born without fertility treatments are twins, and of those about 12 percent are preterm.
Many women who’ve struggled to have kids are excited to have twins—even asking their physicians for twins—because they may not have the money for multiple IVF treatments (each round can cost up to $20k!), or they would love to have two kids at once, and never have to go through pregnancy again! But doctors fear that couples are making a rash decision without really knowing the increased medical risks for babies and moms (risk of gestational diabetes and preeclampsia are higher).
The American Society of Reproductive Medicine’s recent guidelines state that women should be counseled on the risks of multiple births and embryo transfers and that this discussion should be noted in their medical records. According to the guidelines, “for women with reasonable medical odds of success, those under 35 should be offered single embryo transfer and no more than two at a time.” They are open to more embryos being implanted, if the woman is over 35.
According to Valley News, with stronger screening of embryos, success rates for single embryos could be nearly as good as when two or more are used, say experts. The new techniques include maturing the embryos a few days longer, improving viability and allowing cells to be sampled for chromosome screening. Embryos can be frozen to allow test results to come back and more precisely time the transfer to the womb.
Taking these steps with single embryos results in fewer miscarriages and tubal pregnancies, healthier babies with fewer genetic defects and lower hospital bills from birth complications, many fertility specialists say.
I’m really torn on this subject, because I don’t think any of us want more Octomoms running around out there, or kids with health problems. But—and it’s a big but—all of the women I’ve known who’ve had IVF (and I should note that all of them have been over 35), have had twins, and are beyond thrilled with their decision to have multiple embryos implanted. Many of them did have complicated births—including extended bed rest, spotting, C-sections, and breathing problems in the children that caused them to stay in NICU for weeks, up to months after their births.
All of that said, as far as I know every single one of them is a happy, healthy kid with no lingering medical issues (at least so far—fingers crossed!). And even though the pregnancies and births were more complicated, required more doctor visits, and now they have twice the expenses with two little ones running around at the same time, the parents’ love for their two cuties made all of that initial anxiety worth it for them, and they would never, ever want to have traded that experience in for a single birth.
TELL US: Do you think women should be discouraged from having twins? Do you have twins? Tell us your story!
Use our Ovulation Calculator to see when you’re most likely to get pregnant. Then, see the 13 tell-tale signs you’re expecting.
Image of twins courtesy of Shutterstock.
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Baby Names: How To Name Twins and Multiples
Bed rest, C-section, Cesarean Section, fertility, Gestational Diabetes, In Vitro Fertilization, infertility, IVF, Multiples, Preeclampsia, Preemies, pregnancy, pregnant, Spotting, Twins | Categories:
Monday, August 5th, 2013
I’m sure I’m not alone in noticing there’s a major twin trend happening right now. I have three friends who’ve all given birth to twins within the last year, and stars like Mariah Carey, Jennifer Lopez, and Angelina Jolie’s twins are paparazzi favorites. We as a society just can’t seem to get enough of twins. Why? It’s simple. Because there’s twice as much to love!
The double baby boom has been a long time coming. Between 1980 and 2009, the rate of multiple births increased by 76 percent. As of 2012, about one in 30 babies born in the United States is a twin. Two-thirds of the increase is likely due to the growing use of IVF. The remainder is mainly attributed to a rise in the average age women give birth. Older women are more likely to produce more than one egg in a cycle, and 35 percent of births in 2009 were to women over age 30, up from 20 percent in 1980 (This age-induced increase applies only to fraternal twins, though; the rate of identical twin births does not change with the age of the mother).
Due to IVF, many moms-to-be are faced with the question: How many fertilized eggs do I want implanted in my uterus? One is the safest for both mom and baby, but many couples who’ve suffered with infertility are afraid to rely on a single egg per try. Aside from it being a costly process (usually around $10-15k per cycle), the thinking is the more embryos the higher chance of pregnancy. But according to Dr. Amos Grunebaum, a Maternal-Fetal Medicine Specialist at Weill Cornell, having multiple embryos implanted during IVF doesn’t necessarily increase your chances of pregnancy, it simply increases your chances of being pregnant with multiples.
In fact, when a woman carries more than one fetus, it’s less likely that she’ll be able to carry that pregnancy to term. Dr. Grunebaum thinks mothers should ask for only one embryo to be implanted because of the health risks involved with having multiples for both the babies and the moms (In some European countries it’s actually illegal for docs to implant more than one embryo because of the risks it poses to the mother’s health).
About 60 percent of twins are born prematurely (at an average of 35 weeks). More than half of twins are born at less than 5.5 pounds. Low birthweight babies—especially those born before 32 weeks and/or weighing less than 3.5 pounds—are at an increased risk for breathing, vision, hearing and heart problems.
Mothers expecting twins are in danger too. They are more than twice as likely to develop preeclampsia, a mix of high blood pressure, protein in the urine and general swelling that can be dangerous for both mom and baby. Gestational diabetes—which can cause the baby to be larger—is also common, and can increase risks of injury to mom and baby during vaginal births, and can lead to poor feeding, jaundice, breathing problems and seizures in infants. And, finally, women due with twins are more likely to need a cesarean section, which is a more evasive birth with a higher chance of hemorrhaging during and after delivery, and requires a longer period of recovery.
The stress of twins is not over once they’re born, either. Two babies at the same time means more feedings, diaper changes, and temper tantrums. More clothes, gear and childcare, which can add up to be very pricy. But it also means twice the smiles, hugs and giggles too. While the moms of twins I know love having twins, they’ll be the first to tell you it’s an awful lot of hard work—that goes far beyond picking out perfectly coordinated outfits. So think twice before you decide to implant yourself with more than one egg. You might not be ready for what you’re wishing for.
TELL US: Would you want twins? If you have them, how are you dealing with double the work, double the pleasure?
Image of twins courtesy of Shutterstock.
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Angelina Jolie, celebrities, fertility, Gestational Diabetes, In Vitro, In Vitro Fertilization, infertility, IVF, Jennifer Lopez, Low Birthweight, Mariah Carey, Multiples, Pre-Eclampsia, pregnancy, pregnant, Premature Birth, Twins, Twins Pregnancy | Categories:
Healthy Pregnancy, Must Read
Friday, June 7th, 2013
I was struck by the outpouring of feedback Parents received on Facebook after my last blog post, Terminate Your Pregnancy or Your Life? A Breast Cancer Dilemma. People were equally passionate for both sides. Many of you agreed with Laura, the woman who chose to terminate her fourth pregnancy in favor of saving her life so she could continue to be a mom to her three children. Some of you had even had to make that traumatic decision yourself (my heart goes out to each and every one of you!)
But lots of you felt that in the same situation you would have taken the risk and not received chemotherapy or undergone surgery in hopes of saving your unborn child. Many shared stories of friends and family members who took the risk and the baby lived and the mom died shortly after—making the ultimate sacrifice for her child; while others did the same and it paid off with a full recovery for the mom and a healthy baby.
Since one thing you all agreed on is that you care so deeply about the lives of little ones, I wanted to share some good news with you from this article I stumbled upon in the Daily Mail about brave moms who decided not to listen to their doctors’ advice when their pregnancies were seen as high-risk. Please understand that this is in no way an endorsement of going rogue against a doctor’s counsel (only you and your partner can decide what’s right for you and your family after hearing all of the medical facts), it’s merely me wanting to share the flip side of yesterday’s coin.
Imagine you’re an elementary school teacher who always felt she was born to be a mom. You’ve tried to get pregnant for seven years with thee failed rounds of IVF and one heartbreaking miscarriage before finally getting pregnant—with triplets! That’s exactly what happened to Kirsty Woodhouse, now 37. She was expecting identical twins and a singleton (weird name, I know, but it’s a technical term meaning the baby was not a fraternal or identical twin to either of the others). Multiple births are always considered high risk, so Kirsty was quickly advised that there was a 20 percent chance she would miscarry all three and her doctor advised that the best chance of having one healthy baby was “selective reduction,” which meant terminating the identical twins.
The procedure would require a needle to be passed through her abdomen, into her womb that would inject the twins’ hearts with a chemical that would stop them from beating. There was also a risk that the third child would also be affected by the chemical, leaving Kirsty and her husband with no child at all. But that risk was less than if she proceeded with carrying the triplets. If she and her husband went against medical advisement and she miscarried all three babies there was a good chance that she would never birth her own child (of course surrogacy and adoption were always an option).
While getting a second opinion, Kirsty’s new doctor took the positive spin to the same facts and said there was still an 80 percent chance that if she continued with the pregnancy that one or more of the babies could survive. After having seen their babies on Kirsty’s sonograms, hearing their heartbeats and already forming an unconditional love for each of them, Kirsty and her husband’s decision had been made for them. They were too emotionally connected to all three babies to end any of their lives intentionally.
Kirsty’s pregnancy was complication-free from then on out. After a planned caesarean at 34 weeks, now all three 15 month olds are happy and healthy. Kirsty and her entire family can’t bring themselves to wonder what their lives would have been like without these three bundles of joy. For her, all of the stress and worrying was worth it. She chose her own path and it lead to three beautiful babies.
Tell Us: If you were pregnant with multiples, would you risk one baby’s life to save another?
Image of baby courtesy of Shutterstock.
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Abortion, High-Risk Pregnancy, Identical Twins, IVF, Miscarriage, Multiples, pregnancy, pregnant, Triplets, Twins | Categories:
Healthy Pregnancy, Pregnancy News