Transferring multiple embryos during in vitro fertilization to conceive a multiple pregnancy can easily lead to complications of twin blood transfusion, miscarriage, premature birth, and increased risk of cesarean section.
“Many people make the mistake of thinking that giving birth in one body, giving birth once and for all, infertile twins is a blessing,” said People’s Physician, Associate Professor Dr. Le Hoang, Director of the Reproductive Support Center, Hospital. Tam Anh Hanoi General Hospital, said on May 24, adding that a healthy developing fetus is safer than many fetuses.
During the process of treating infertility with in vitro fertilization (IVF) for infertile couples, Associate Professor Le Hoang often receives requests to “transfer many embryos into the uterus”. They want to “do one and get two or three” due to fatigue after many years of failed IVF, or lack of time, worry about expensive costs, and fear of failure the next time.
According to Associate Professor Le Hoang, the rate of multiple pregnancies with IVF is about 20-30%, most of which are twins, many times higher than with natural conception (only 2%). Doctors often advise to reduce pregnancy and it is best to keep one pregnancy to ensure safety for mother and child. However, many families choose to keep twins despite the risks.
Having multiple pregnancies is not good for the health of the mother and fetus because according to natural physiology, the uterus nourishes one fetus best. At this time, the mother increases the risk of anemia, hypertension, diabetes, uterine rupture, placenta accreta, cesarean section, hemorrhage, and even death. The fetus is at risk of complications from twin blood transfusions, miscarriage, premature birth, growth retardation, placental cord around the neck…
The risk of premature birth in this case is very high. At Tam Anh General Hospital, 85% of women with multiple pregnancies gave birth prematurely before 32 weeks. Premature fetuses are at risk of low birth weight, increased respiratory problems, increased risk of infection, brain hemorrhage, jaundice and retinopathy.
Doctor at Tam Anh IVF Center advises an infertile patient. Image: IVF Tam Anh
For example, Ms. Lan, 36 years old, pregnant with twins, came to Tam Anh Hospital because of a recurrent twin blood transfusion at 27 weeks of gestation. The donor fetus had reduced circulating volume, leading to oliguria, oligohydramnios, and delayed delivery. growth. The fetus receives polyuria, an enlarged bladder, polyhydramnios, edema, and heart failure due to excessive circulatory volume expansion. The doctor and his family decided to have surgery to keep one fetus to increase the chance of survival, safety for the fetus, and limit the cost burden.
At week 27, the amniotic fluid is no longer clear, limiting the surgeon’s view. Fetal movement can easily obscure the surgical field, and blood vessels are quite large, increasing the risk of bleeding. Luckily the surgery was successful and the mother was able to keep a developing fetus in her uterus.
Another case is Ms. San, 35 years old, who transferred two bean embryos to twins after 7 years of infertility. At 18 weeks of pregnancy, she had gestational diabetes, cervical insufficiency, risk of miscarriage, and amniotic leak, so she had to stay at Tam Anh Hospital to keep the pregnancy. One fetus showed signs of slow growth, the pregnant woman had pre-eclampsia, and had to have a cesarean section at 29 weeks. Two premature babies had respiratory failure and were hospitalized in the Neonatal Department for intensive care and treatment, with expensive treatment costs. .
Similarly, Ms. Hong, 37 years old, infertile for 8 years, had IVF. The doctor advised her to keep one pregnancy, but she was determined to keep them all. At the 16th week, the pregnant woman had heavy vaginal bleeding, her blood pressure dropped rapidly, and her condition was dangerous because she lost a lot of blood. The family must choose to terminate the pregnancy to stop the bleeding, preserve the uterus and the mother’s life.
According to Associate Professor Le Hoang, in the past, when IVF techniques were still limited, many couples asked to transfer 2-3 embryos into the uterus to increase the success rate. Today, thanks to modern techniques, the success rate when transferring one embryo to the uterus is higher than transferring many embryos.
Associate Professor Le Hoang advises an infertile patient. Image: Tam Anh General Hospital
At Tam Anh Hospital, infertility patients are advised to transfer only one good embryo, ensuring a safe pregnancy and healthy birth. Embryos are cultured in a Timelapse cabinet with stable environmental factors such as the mother’s uterus, continuously monitoring the division of the embryo. Techniques to support embryo escape, pre-implantation genetic testing, sperm injection into oocyte cytoplasm… help transfer the best quality embryos into the uterus, increasing conception rates.
The average success rate is 71.5%, equivalent to transferring many embryos but avoiding the risk of multiple pregnancies, the multiple pregnancy rate is just under 10%.
Dr. Le Hoang recommends that women should proactively prevent multiple pregnancies by reducing the number of embryos implanted in the uterus. Infertile couples should also choose a reputable fertility center for advice and support to have healthy children. Women pregnant with twins need scheduled prenatal checkups to detect abnormalities early.