Lowering the Chances of Multiple Births Charlotte Meyers

 

Many doctors have responded to the latest consequence of the success of an in vitro fertilization.  Often I.V.F is often too successful and since 1980 when that technique became available in the United States the rate of twins climbed 70 percent.  The rate of triplets and higher-order multiples increased even more from 1980 to 1998.  Having twins or triplets is not undesirable, however, multiple pregnancies often lead to risky premature births and other complications.  That is why doctors are trying to find a way to decrease the chance of such a birth.

In I.V.F a woman is given ovulation inducing hormones to produce multiple eggs.  The eggs are retrieved, fertilized, and transfered back into her uterus.  The more embryos that are transferred, the more likely it will be that the woman will have multiple children.  In order to try to get one single baby, doctors are focusing on transferring fewer embryos and on developing a more sophisticated way to find the healthiest embryos.  Although efforts have lowered then rate of triplets born substantially, doctors have not made a dent in the twin rate.  That is because many doctors and patients have hesitations about ensuring a single birth.  To ensure a single birth only one embryo can be transferred. 

The main obstacle in single embryo transfer is the lower success rate.  With all that pressure on the one embryo, clinics are trying very hard to find the embryo that is most likely to succeed.  Usually selecting embryos was based on a physical examination of their morphology.  However, morphology does reveal everything and many embryos that look great under microscopes have undetected chromosomal abnormalities.  One method of taking out the unhealthy embryos is to leave the embryos in a Petri dish for five days, two more than usual, in order to allow more time for hidden chromosomal abnormalities to show up.  Other doctors are turning to genetics to obtain embryos without missing chromosomes.  This screening selects healthy embryos in families with histories of genetic diseases.  However, there is some concern that this process an damage embryos.  All these tests are not really getting anyone anywhere because women are still refusing to have just one embryo put in.  Many women do not think having twins is risky and in fact many are happy to speed the process of completing their family.  Carrying twins or higher- order multiples raise the risk of premature births, low-birth-weight babies, the possibility of death in very premature infants, long term health problems and pregnancy complications.  Even with all those risks women take comfort in the improvements in care. The survival rate for newborns over two pounds three ounces is 85 percent.  Many people also blind themselves by only seeing the adorable twins in the double strollers and not the twins that do not make it out of neonatal intensive care. 

Many doctors think that the biggest problem is coming from ovulation induction.  If ovaries are too aggressively stimulated with hormones a woman can produce a nest full of eggs and increase the risk of having triplets, quadruplets, and even sextuplets.  All ovulation induction cycles should be closely monitored and in some cases cancelled if there are too many embryos. 

With this new information there are many new possibilities.  With some more research women could potentially chose the number of children she wants to have.  Also, these treatments could one day be used as a way of achieving population control. 

 

References:

1.      http://www.aium.org/images/patImgGallery/5.jpg

2.      http://www.nytimes.com/2008/02/19/health/19mult.html?_r=1&ref=science&oref=slogin