Strollerderby

Doctors Want Fewer Twins

Posted by Madeline Holler

Doctors are suddenly on a tear to reduce the number of twins and triplets born in the U.S. Twins are everywhere and triplets aren't really all that original anymore either thanks to advances in fertility treatments.

But considering the health risks multiple births pose to both moms and babies, those in the business are looking for ways to lower the number of triplet -- and even twin -- births.

For starters, they want to implant fewer fertilized eggs. But everybody knows fertility treatments cost a fortune.  

From the NY Times:

“People have to recognize that there’s a connection between cost and how the treatment is going to play out,” said Barbara Collura, executive director of Resolve, a patient advocacy organization for people with infertility. “If you have $10,000 that you’ve begged, borrowed and stolen for this one I.V.F. cycle, you’re not going to say, ‘Please just transfer one.’ ”

Others want to wait five days after the extracted egg is fertilized instead of only three. That gives more time for abnormal chromosomes to be revealed, thereby disqualifying a greater number of embryos and allowing fewer to be transfered while maintaining the odds one will turn into a viable pregnancy.

Better screening, fewer embryo transfers, and telling would-be moms of the risks that mulitple births carry is the plan so far. What else? Do you think multiple births are a problem? What was your experience?


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Comments

 

Autumn said:

Sometimes people like it because it is instan family with only one pregnancy. But the medical risks are high especially for older moms who need the treatments in the first place.  I think docs should encorage parents to go for one at a time.  Right now they encorage implanting multiple embryos to get their success rate numbers up.  

February 19, 2008 11:52 PM
 

catem said:

Ugh, they do NOT implant embryos... this is such a widely used term that is so incorrect.  They transfer them and HOPE for implantation.

Sorry, it hits a nerve w/me every time I hear/read "implant embryos" as that was my big issue during the 7 cycles of ivf, lucky 7 being a success with twins.  

Yes, I had twins and thank god they are healthy!  This was after a high risk pregnancy and 3+ months of bedrest (cervix issues that would've been an issue w/a singleton, too).  Having had such a bummer experience (both w/pg and getting there), I'm thrilled that I was blessed with twins.

Every case is such an individual one that it's hard to put a blanket ruling in place.  I had major immune system issues that I discovered after cycle #6 that ended up not having anything to do w/our embryo quality (which tends to govern the # of embryos transferred).

Bottom line, it's a case by case choice made between doctor and patient with lots of counseling.  I know the top clinics take multiples in pregnancy (HOM) very very seriously - it seems that it's the lesser ranked ones that need better guidance both for their patients and SARM doctor to doctor guidance.

The idea of single embryo transfer has merits but is nearly financially impossible unless ivf becomes mandated by each state and is covered by insurance.  $10,000 is a very low estimate, btw.  That's not including all the drugs and any other procedures one might need.

February 20, 2008 1:45 AM
 

cooper1178 said:

catem, you can correct me if I'm wrong, I'm a fertile Myrtle and only know as much as I've read.  But I've always been under the impression that IVF isn't the reason multiples are on the rise and such a problem, it's the cost of IVF forcing people to seek other alternatives that's the problem.  IUI has a much higher risk of multiples, and high-order multiples at that, but is much less expensive than IVF.

I think the bottom line is that infertility treatment needs a big overhaul so that those that want children can do so without breaking the bank.

February 20, 2008 12:10 PM

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