"Risk" of multiple birth

chicagobride_07

I've seen this on websites and my RE also referred to this last week.  Is this really a "risk"?  I get that we don't all want to be Octomom, but honestly, I'd be overjoyed with twins.

Is there something I am missing on why multiples would be an undesirable outcome of IF treatment?

Thanks!

brooklynesque

Here's a good article on the subject.  (Sorry can't make clicky.)  https://www.shadygrovefertility.com/newsitem/npr-reports-taming-twin-trend-fertility-treatments

hugmonkey

I believe that any time you are carrying more than one baby, you may be at higher risk of complications such as gestational diabetes.

Aegis2005

There is potential risks for both the mother and babies.  PP link is a good summary.

luvboston

For centuries woman have had twins and triplets, as long as the mother is healthy things should go fine. They over scare patients so that if things go wrong they don't get blamed. Personally I will be overjoyed even with all my issues to have twins because its a 2 for 1 deal as we pay OOP.

annalisel

brooklynesque:

Here's a good article on the subject.  (Sorry can't make clicky.)  https://www.shadygrovefertility.com/newsitem/npr-reports-taming-twin-trend-fertility-treatments

Great article. I'd always known that twins tend to be less healthy and have slightly lower IQs, but I didn't realize how common more serious problems were. Thanks for sharing.

SLPMel

Warning **SAIF ticker**

There is most definitely a risk.  I went on bedrest at 25 weeks.  I went into Preterm Labor the first time at 29 weeks, in which a neonatologist came down to talk to me about what my babies would be facing if they came that day, and it included bleeding of the brain, being on a vent, weeks/months in the hospital, along with possible other consequences-Long term consequences-cerebral palsy, developmental delays, vision/heart/feeding issues.

Then they tried to come again at 32 weeks.  I spent more time on hospital bedrest.  And on home bedrest.  I was out of work for almost 10 weeks before they came-luckily I had full payment of my salary the whole time, and it didn't impact my ability to take another almost 17 weeks-I was definitely one of the lucky ones.

A twin pregnancy was hard on me physically-and I was one of the lucky ones that got to over 35 weeks with my twins and it included no NICU time.  I thank my lucky stars many, many times that I did not lose my twins prematurely, or that we didn't have weeks or months of NICU time.  A local news anchor had her twins at the exact same time as I went into PTL and delivered her boys.  They were in the NICU for 11 weeks. The financial cost, the emotional and physical difficulties-all associated with your children born prematurely.  60% of twins are both prematurely, and 90% of triplets are as well. 

You are also are twice as likely to experience pre-eclampsia if carrying twins, and your risk for Gestational diates increases as well.  The risks involved with both of these impact both the health of the mother as well as the babies.  We think that my DS had interuterine growth restriction due to the pre-eclampsia that I was experiencing.  If my pre-eclampsia had been severe enough, I could have had a stroke.  We luckily caught it in time.  Other issues include placenta previa, premature rupture of the membranes, as well as post-delivery hemorrhage. 

I love my twins-and it was worth everything I went through to get them-but I also wouldn't wish the struggles and risks to me and my children.  We were very lucky to have two healthy babies-but we got extremely lucky.   There are many people who have their twins before they are viable. 

I was very happy we were pregnant with twins-but I also didn't realize how much of a risk I was taking.   There is a higher risk of post-partum depression/anxiety.  Another impact-parents of multiples are at a higher risk of divorce-the increased costs involved, less sleep, etc impacting the relationship of the parents.

I think it is a fine line to walk between decreasing risks associated with multiples and the increased chance of success.  Twins is hard-but IF was hard as well.  I don't think twins are bad-I just don't think the reality of twins is what most people think of when they think about getting pregnant with twins.

KdgTeacher

luvboston:

For centuries woman have had twins and triplets, as long as the mother is healthy things should go fine. They over scare patients so that if things go wrong they don't get blamed. Personally I will be overjoyed even with all my issues to have twins because its a 2 for 1 deal as we pay OOP.

I bet you could take that statement over to the Multiples board and get quite a few "healthy women" who had complications--bedrest, pre-term birth, etc.  Healthy =/= an easy pregnancy or healthy babies.

Mrs_Liberto

KdgTeacher:

luvboston:

For centuries woman have had twins and triplets, as long as the mother is healthy things should go fine. They over scare patients so that if things go wrong they don't get blamed. Personally I will be overjoyed even with all my issues to have twins because its a 2 for 1 deal as we pay OOP.

I bet you could take that statement over to the Multiples board and get quite a few "healthy women" who had complications--bedrest, pre-term birth, etc.  Healthy =/= an easy pregnancy or healthy babies.

Yeah, agreed. That's a pretty ignorant statement to make. 

ETA: there are multitudes of dangers that go along with "just" twins surrounding their early births, too. Retinopathy of prematurity (vision problems), breathing problems, learning disabilities, higher likelihood of getting RSV, heart defects... the list goes on. Then add in daycare/health insurance/medical bills for two. Add in the increased likelihood of bedrest and being out of work earlier + all the risks to the mother that PPs have mentioned like pre-eclampsia, etc.

Go lurk on the preemies board or the multiples board - multiples aren't just a walk in the park.

LaLe09

Yes, you AND your babies are at a much higher risk of complications. I'd definitely do some research if you do not believe this. It's there. In addition, i''ve worked in nicu for over 6 years and can say with certainty, having multiples greatly increases these risks. Yes, there are plenty of healthy twins too, but your risk is increased. Shady grove has really pioneered the way for the sET. They have shown that the sET is cost effective when it comes to the potential costs of complications of a multiple pregnancy.

farmerlynda

SLPMel:

I think it is a fine line to walk between decreasing risks associated with multiples and the increased chance of success.  Twins is hard-but IF was hard as well.  I don't think twins are bad-I just don't think the reality of twins is what most people think of when they think about getting pregnant with twins.

I couldn't agree more with what SLPMel said.  

At first, DH and I were dead-set against twins for all of the reasons PPs mentioned... higher risk pregnancy for me, higher risk of complications for the babies, not to mention the insane amount of work and stress associated with bringing home not one but two newborns!  We were pro-eSET all the way and we went into our ET planning to transfer 1 high quality blast. 

Then our embryo quality went to hell, and the RE told us in the procedure room to transfer the best three, and even with that, our first IVF cycle failed.  Now, while we still recognize the risks of a twin pregnancy, we have to weigh those risks against the emotional and financial risks of another failed cycle. 

It's a tough spot to be in.  We would still prefer a singleton but DH and I actually just had a conversation today in which we agreed that our feelings towards twins had changed.  We know that in the future we may be at risk for multiples because of having to transfer multiple embryos due to our quality issues.  And I think we've made peace with that, and would welcome twins... but it's not at all a decision we've made lightly. 

If I could close my eyes and pick two singletons instead, I would.  But that's not the way IF works.  This whole thing is one giant gamble.

Trish11278

I know a lot of us would love to have twins especially with the struggles we have gone through so far.  Although, having multiples does increase your risk for complications to you and your babies.  This is what your RE wants you to be aware of.

DesiraeSunshine

Risk??????? I lost twins at almost 20 weeks due to PTL. I was healthy as were they. No matter how healthy, some peoples bodies cant handle twins. Im sorry, I just hate the "id be overjoyed with twins" comments. Just realize that not all is happy in twin land and its never going to be a normal pregnancy.

Ruthie04

As a patient of Shady Grove, I have been given plenty of literature about the risks of multiple pregnancy. They are very upfront about the dangers and they really encourage patients to transfer one embryo, when appropriate. DH and I did an eSET last time and (pending quality) I think we will do an eSET again. Not only are there dozens of dangers in carrying a twin pregnancy, but parenting twins is hard work! My SIL has twins from an IUI cycle. She had a beautiful pregnancy and delivered full term twins. But, recently she had abdominal surgery to repair a split in her stomach muscles and correct her prolapsed bladder. The stress of the pregnancy was so difficult on her (very healthy) body. And, I've seen how hard it has been to parent two babies/toddlers/children. She always says she feels like she hasn't been the parent she wanted to be because of he demands on her attention. When we told her we were doing an eSET, she was thrilled. 

It's hard not to get wrapped up in the "two for one" hype, but at the end of the day, a multiple pregnancy and parenting multiples is a difficult and risky task.

BeeBee08

DesiraeSunshine:

Risk??????? I lost twins at almost 20 weeks due to PTL. I was healthy as were they. No matter how healthy, some peoples bodies cant handle twins. Im sorry, I just hate the "id be overjoyed with twins" comments. Just realize that not all is happy in twin land and its never going to be a normal pregnancy.

Exactly this, and DesiraeSunshine is not the only person on this board that experienced the complications firsthand with a twin pregnancy.  Does it sound nice to have a "2 for 1 deal"?  Yes.  Do most twins go on to be healthy newborns?  Yes.  But is there increased risks associated with twin pregnancies?  YES!!!  Your doctor doesn't make up risk warnings just to scare you - they're real! 

Sarah226

OMG I should not have read this thread as I just transferred 2 blasts.  Of course, of course, I will be thrilled if they both stick, but now I'm extra terrified.  Mixed emotions!

krismott25

****lurking/ siggy warning******

I'm a product of IVF/twin pg, and while i'm overjoyed with being pg with twins, there are risks. Pre term labor, low birth weights, NICU babies, bed rest and the list goes on. Like I said I'm really happy after 3 IVF cycles that we are having twins, but the fear is sometimes almost paralyzing. Not to say you wouldn't have that in a singleton pg but your risk is higher with multiples. You also have to have closer monitoring by and MFM to make sure they are growing. plus (again not complaining) you have to in a way grieve the loss of a "normal" pregnacy and birth experience. it also depends on what kind of twins you get mono/mono mono/di di/di. basically are they sharing a sac and placenta. di/di twins are at least risk because they have their own sac and own placenta. then think about when the babies do come.... your up all night with 2 babies changing 2 butts, breasfeeding 2 mouths. I am so grateful at this point but at the same time i would be lying if i didn't kind of think how it would be with one. i'm worried about sharing the love if you know what i mean. hope this helps

****lurker out****

chicagobride_07

Thanks, ladies.  I appreciate all your perspectives.  I am relatively new to TTC- due to my age and extremely low AMH my GYN sent me directly to an RE.  It helps to learn from all of your experience- I understand now.

PrettyAccountant

Sig warning and pg mentioned

Yes that is a REAL risk. I am currently pg with triplets (almost 12 weeks) and this pregnancy has been one big ball of stress. When I sat down with my MFM he laid out all the risks with carrying multiples. Even carrying a singleton carries risks but they are magnified when carrying multiples. I have been told that the best they can hope for is a 34 week birth and 5 lb babies - Mind you - that is the best. I know a number of fertility clinics are beginning to view higher order multiples as a failure of the system.

As far as as long "as the mother is healthy" bit - that is a load of non-sense. It helps if the mother starts off healthy but that does not always equal healthy babies or a desirable outcome.

Good luck! 

nuttycoconut

*lurker here too*

See my siggy for the risks involved in having twins.  I was ecstatic at the thought of getting "2 for the price of 1" but instead got 0. And I had to say goodbye to my beautiful daughter and son.    I'm a very healthy person who went to appointments every other week and was seen by some of the best doctors in the Northeast. You just never know what will happen, especially with a first pregnancy.  The doctors say if I had a singleton pregnancy, I probably would have gone full term. The RE refuses to transfer more than 1 embryo at a time now, so no more twins for me. And I can't believe I have to start this process all over again. I do wish you the best of luck and hope you never have to experience this pain.

cottonlily84

I guess it boils down to what you can handle.  Some people don't want, can't afford or would prefer not to have 2 children.  Two at the same time the same age is an even bigger responsibility.  My aunt had IF issues for way longer than I went through and wound up with twin girls.  I helped her one summer and will never forget how hard it was.  So I was really afraid that I would get pregnant with twins (triplets or more were very unlikely).  My RE put me on femara instead of clomid, monitored the follies, we weren't doing IVF - but I still worried about it.  I held my breath at every u/s until they assured me it was only 1.  I knew then and know now how selfish that sounds, with other people wishing for anything they could be blessed with, but it's how I felt.  Of course it sounds silly now.  Had I had twins I would have managed somehow.  When we start TTC again I won't worry about it.  Being a FTM I just didn't think I could handle 2 babies but now that I have one I know I could.  I think the "risk" drs are referring to is more of the octomom situation because that many babies puts mom and babies at more of a health risk. 

DesiraeSunshine

::facepalm::

mdluv21

Points to my signature. 

Twins carry a very high risk and having to give birth to your babies and watch them die (especially after going through IVF) is absolutely heartbreaking and I would never wish on my worst enemy.

I know it is hard to avoid multiples with ART and the cost etc. but yes getting pregnant with twins lowers your chance of getting a take home baby.  (All of this said knowing that there is also plenty of successful twin pregnancies.)