Facebook Live – Basic Information About IVF and Twins/Multiples

Dr. Silber answers a viewer question from Facebook Live. Dr. Silber discusses the statistics and situations surrounding IVF and multiple pregnancies – twins, triplets, etc.

 

Video Transcription:

Multiple pregnancy is really a potential disaster and I’m not talking about “well, it’s so many kids to take care of at one time like triplets, quadruplets, quintuplets..” That’s not the issue I’m talking about. But they are dangerous pregnancies. so the question in many academic circles the push is on for single embryo transfer so you can avoid even twins. and we’ll do single embryo transfer but the majority of American women like two embryos transferred because IVF is expensive even mini-IVF is any IVF is expensive and they want to maximize their pregnancy rate for transfer – not just do one at a time. Now they could do PGS but the genetic screening of PGS is terribly inaccurate and you’re going to end up throwing away normal babies and so you know the idea is to try to do a single embryo transfer and have the same pregnancy rate as two embryos. Most American women actually want two embryos and they actually are happy to have twins and in some cultures, academic cultures mostly, the emphasis is on single and if they want a single embryo transfer that’s great we’ll be glad to do that. But most of our patients request two – we won’t transfer more than two unless, by ASRM guidelines, they are over 40 years old and it’s considered pretty safe for a 43 year old to transfer three embryos because you’re just hoping you’ll get one to take and you’re not going to have triplets from that. so it’s up to the woman to decide what she wants to do. The thing about a twin pregnancy is it’s a more difficult pregnancy and there’s a higher incidence of early birth but frankly in the hands of our obstetricians – and I’m not an obstetrician – I’m an infertility doctor. When the hands of our obstetricians, the twins really do great but it’s a more difficult pregnancy and if it’s early the the child will be in the hospital longer. It’s more expensive to the insurance companies they have to cover it but if the insurance companies would cover IVF then everybody’d be happy to have a single embryo transfer but since they don’t cover IVF most patients in America want two.