More than half of couples seeking IVF often want twins or triplets but are not aware of the health risks posed by multiple pregnancies, experts warn.
Most IVF couples in UAE want multiple births, but don’t know the risks
ABU DHABI // More than half of couples seeking IVF often want twins or triplets but are not aware of the health risks posed by multiple pregnancies, experts warn.
They say many prospective parents feel twins or triplets were more desirable, that they would complete their family more quickly, or, because of the high cost of fertility treatment, they want multiple births from one cycle of in vitro fertilisation (IVF) and so ask for the implantation of several embryos.
But this can carry the risks of premature birth, low birth weight, pre-eclampsia – a combination of high blood pressure, protein in the urine and generalised swelling that can be dangerous for mother and baby – gestational diabetes and a higher chance of miscarriage.
“In general women come to have IVF with the idea of having twins, especially after being deprived of having children for five, six or seven years,” said Dr Majeed Aloum, the head of the IVF centre at Al Noor Hospital’s Khalifa branch.
Speaking on the sidelines of the International Conference of Al Noor Hospital on Thursday, the consultant obstetrician and gynaecologist said: “They cannot resist the idea of having twins with IVF but most of them do not appreciate the risk involved with having multiple pregnancies, especially with triplets or pregnancies among older women.
“Generally, we do try to advise them or make it clear to them. Yes it is nice to have twins but apart from being hard work for the mother and a sort of burden for the family, the risks, for say, all types of congenital abnormalities, with twins increase and the risks of illness to the mother increase – such as high blood pressure.
“Lots of complications come with multiple pregnancies.”
The risk of premature birth is triple-fold in twins and far more for triplets, he said.
More than half of women seeking IVF are hoping for a multiple birth, he said, and want to transfer a large number of embryos.
But the best and safest method is to transfer one.
More education was also needed to dispel some of the myths surrounding IVF, he said.
Because the cost of IVF is high – about Dh30,000 for a cycle – couples hedge their bets and believe multiple embryos will increase the chance of a successful pregnancy but this is not the case, said Dr Aloum.
“The first thing I would try to tell women is not always increasing the number of embryos transferred increases the pregnancy rate.
“People think by transferring three, four, five embryos they are going to have a better chance of getting pregnant. And financially some patients can only afford to have one cycle, so they want to put the most they can in so that the cycle succeeds.
“We try to tell them having triplets is not always a success because they may lose them at three, four or the fifth month of pregnancy because the risk of miscarriages are higher.”
It is about the quality of the embryo rather than the quantity, he said, and it is a doctor’s responsibility to explain the health risks.
“I think in different countries, like in England, people are more aware of the risks. But here they are not so aware.
“By transferring more than one embryo we increase the risk of multiple pregnancy and I would explain the risks to the mother. They may be happy with having twins but they will not be happy having problems with them as well.
“Triplets and quadruplets carry further problems.”
As a rule, no more than two embryos should be implanted.
Dr Afshin Mirza, specialist in obstetrics and gynaecology at the foetal medicine and genetic centre at Dubai Healthcare Clinic, suggested a cap on the number of embryos allowed to be transferred
“This is a very hot topic. A lot of people come to me. They say ‘oh I want to have twins’. They are all focused on celebrities. They see they are having twins. They say ‘oh, this is great’. But our job as a doctor is to guide them,” said Dr Mirza.
Explaining the health risks associated with multiple pregnancies, he said: “I would say to mothers: avoid high-risk pregnancies. Twins and triplets are a high-risk pregnancy. Premature deliveries, deafness, brain bleeding, lung defects. It is a long list.”