Today we’re delving into the fascinating world of in-vitro fertilization (IVF) and exploring the potential for twins in this process.

One of the most common misconceptions about IVF is that it always results in twins, which is not necessarily true.

So what’s the truth? Well, it’s time to find out!

What Happens in IVF?

In Vitro Fertilization (IVF) is a complex series of procedures employed to assist with fertility or prevent genetic problems. It has been a beacon of hope for numerous individuals and couples struggling with fertility issues. Let’s delve deeper into this fascinating procedure.

In contrast to natural conception, where typically one egg or oocyte matures during a menstrual cycle, IVF requires multiple eggs.

Let’s break down the IVF process into simpler steps:

• Stimulation of the ovaries: The woman is given gonadotropin injections. These are hormones that stimulate the ovaries to produce more follicles than they normally would in a regular menstrual cycle.
• Egg Retrieval: When about 10-12 follicles have matured, doctors are likely to retrieve around eight eggs. This process is also called as Ovum Pick Up process.
• Fertilization: These eggs are then combined with sperm in a laboratory, mimicking the natural fertilization process. Out of the eight eggs retrieved, about 5-6 embryos are viable for transfer into the woman’s uterus.
• Embryo Transfer: Depending on the case’s specifics, this transfer may take place on the third or fifth day of the IVF cycle. Sometimes, doctors let the embryos develop into blastocysts, a more advanced stage, before initiating the transfer.

Twins in IVF: A Closer Look

The fascinating possibility of multiple births in an IVF cycle is one that intrigues many. However, it’s essential to understand the process and why this might occur.

During an embryo transfer on the third day of the IVF cycle, more embryos are transferred because of the uncertainty surrounding how many will develop into babies. The implantation of these embryos depends on several factors:

• Quality of the Endometrium: The lining of the uterus, known as the endometrium, should be receptive enough for the embryos to implant and grow.
• Genetic Health of the Embryo: The embryo itself should be genetically healthy to ensure successful implantation and growth.

To enhance the success rate of IVF, more than one embryo is usually transferred. If the transfer occurs at the blastocyst stage, the chances of having twins or even triplets may increase due to the more mature state of the embryos.

However, certain conditions within the uterus might prevent implantation even when two blastocysts are transferred.

Success Rates of Embryo Transfer

When a patient wants a single child, the doctor often gives an option to proceed with a single embryo transfer, but with a caveat of a lower success rate. The success rate for a single embryo transfer on day three is around 15%, while a single blastocyst transfer on day five has a success rate of 20-25%.

This could mean that patients may have to go through the cycle again if the first attempt doesn’t lead to pregnancy.

Twin Pregnancy in IVF

In Vitro Fertilization (IVF) can sometimes lead to twin pregnancies, especially when more than one embryo is transferred. However, this journey comes with its own set of unique aspects and potential complications. Here’s a brief overview of what you might expect:

• Risks Associated with Multiple Pregnancies: The human uterus is generally designed to carry one foetus at a time. When two or more embryos implant and develop, it may lead to certain complications.These could include an increased likelihood of bleeding, a higher risk of miscarriage, or a premature birth. The birth weight of the babies might also be lower compared to single pregnancies.
• Chances of Single Implantation: It’s important to note that not all embryos transferred will necessarily implant. For instance, if two embryos are transferred, there might be cases where only one successfully implants and develops. The other embryo might be naturally absorbed by the body or expelled.
• Uncertainty in Early Stages: During the initial stages of pregnancy, ultrasound scans might show two sacs, indicating a potential twin pregnancy. However, this doesn’t guarantee the development of twins.There might be instances where one of the sacs does not progress, resulting in a singleton pregnancy. Therefore, it’s essential to understand that seeing two sacs in the early scan doesn’t necessarily confirm a twin pregnancy.

Navigating a twin pregnancy in IVF can be a complex process with additional factors to consider.

Challenges of Multiple Pregnancies in IVF

Carrying multiple pregnancies, such as triplets, in an IVF cycle, can present several unique challenges:

• Rare Survival Rate: It’s unusual but not impossible for all three embryos to survive until the 12th week of gestation. This scenario can be influenced by various factors such as the mother’s health, the embryos’ quality, and the overall gestational environment.
• Difficulty in Full-Term Pregnancy: Carrying a triplet pregnancy to full term is often challenging. This is due to the added physical strain on the mother’s body and the limited space within the uterus.
• Premature Delivery: Due to the complexities associated with carrying multiple pregnancies, a premature delivery might be necessary. This means the babies would be born before the standard 37 weeks of gestation, which could lead to potential health issues for the newborns.
• Additional Health Risks: Carrying multiple pregnancies increases the risk of certain health issues for the mother, such as preeclampsia, gestational diabetes, and other complications.
• Emotional and Financial Strain: Multiple pregnancies can lead to increased emotional and financial stress. The cost of healthcare, especially for premature or multiple births, can be substantial, and the stress of managing more than one newborn can also be significant.

This summary highlights the need for careful consideration and medical consultation when pursuing IVF treatment, particularly when there’s a chance of multiple pregnancies.

Concluding Thoughts

It’s crucial to understand all these aspects before proceeding with an embryo transfer. IVF can indeed increase the chances of a twin pregnancy, but it isn’t a guarantee.

The process depends on many individual factors, including the number of embryos transferred, the stage of transfer, and the conditions within the uterus.

Our dedicated team of experts is always here to help you navigate these intricate processes. If you need more personalized information or have any queries, feel free to consult with our fertility experts.

Together, we can help bring your dreams of parenthood to life!

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• About Author

  Dr. Supriya Puranik

  Gynaecologist & IVF Specialist

Often known as the last glimmer of hope for people who have lost all hope for conceiving a child, Dr. Supriya Puranik is a leading gynaecologist, high risk obstetrician and Head of IVF & Gynaecology department at Ankura Hospital for Women & Children.