Why is a singleton pregnancy healthiest? – fertility clinic Scottsdale area

At Reproductive Health Center, we aim for a singleton pregnancy with every patient. That means a pregnancy with just one baby at a time. This is why we transfer just one embryo per cycle in 70% of our IVF patients under 36 years of age.

Why is it healthier to have just one baby? Why don’t we just transfer lots of embryos to make sure that the patient gets pregnant? What problems can happen if the mother is pregnant with twins?

Health risks for the babies – fertility clinic Scottsdale area

Being in utero with another baby causes serious health risks for a twin. Twins are more likely to be delivered prematurely, with about 60% of twins being born prematurely (before 37 weeks). In addition, twins are more likely to be born with a low birthweight, with about half of twins being born underweight (less than 5.5 pounds). With triplets or quadruplets, the likelihood of premature birth and low birthweight rises even more.

Those extra weeks in utero make a big difference, and premature babies have a much higher risk of health complications. They may have health problems during the newborn period, such as breathing problems, and often must spend time in the hospital before going home. Some of the possible lifelong consequences for the babies include cerebral palsy, mental retardation, vision loss, and hearing loss.

The risk of gestational diabetes is also higher in twin pregnancies. This can lead to several undesirable health outcomes for the babies, including excessive birth weight, premature birth (with all of its associated complications), trouble breathing as a newborn, and a higher risk of having diabetes later in life.

In addition, a twin pregnancy carries a higher risk of placental abruption. This is when the placenta detaches from the uterine wall. It can lead to growth problems, premature delivery, or stillbirth. Placental abruption is also dangerous for the mother, with a risk of significant blood loss.

Health risks for the mothers – fertility clinic Scottsdale area

The mother of twins is also at risk for health complications. The risk of pre-eclampsia is considerably higher in twin pregnancies, with women carrying twins being two to three times more likely to have it. In pre-eclampsia, the mother’s blood pressure goes up, her kidneys leak protein, and she experiences generalized swelling. This is a life-threatening condition.

The risk of gestational diabetes, which affects the babies as well, also creates health problems for the mother. Her risk of experiencing a difficult delivery for the twins is higher, and she also has a higher risk of having diabetes herself in the future.

Even without gestational diabetes, having twins increases the chance of needing a cesarean delivery. With this type of delivery, there’s an increased risk of bleeding or infection. Cesarean deliveries also tend to require a longer recovery period than do vaginal deliveries.

Single embryo transfer is the safest option – fertility clinic Scottsdale area

For many women, transferring just one embryo is the safest option. Studies have shown that in certain groups of patients, the difference in pregnancy rates is negligible between women who have just one embryo transferred and those who have two embryos transferred. Although many couples think of the second embryo as “insurance” that they’ll actually get pregnant, the truth is that in many cases, it just increases the chances that the pregnancy will be a twin pregnancy instead of a healthier singleton pregnancy.

The decision about how many embryos will be transferred during a cycle is very personal. It depends on many different factors, including the woman’s age, her overall health, the types of fertility problems that the couple is experiencing, the quality of the embryos, and more.

At our clinic, 70% of our patients under age 36 receive a single embryo transfer. For other patients, we transfer as few embryos as we can while still maintaining a good pregnancy rate, with the maximum number being four embryos. Some fertility clinics try to “pad” their fertility success rates by transferring several embryos into each woman during each cycle, without worrying about the possibility of multiple births. We don’t practice this way, because we want the healthiest outcome for every family, which is a single baby at a time.

Any healthy embryos that aren’t transferred can be frozen for use in future cycles. Rates of pregnancy when using frozen embryos are as good as or even better than those with fresh embryos. Often, the egg retrieval and fertilization cycle will result in more embryos than are needed for transfer, but this doesn’t mean that they all must be transferred.