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In decades gone by, it was not uncommon for women undergoing in-vitro fertilisation (IVF) treatments to conceive multiple pregnancies resulting in twins, triplets - or possibly more babies.
Occasionally resulted in more than one foetus
Doctors would routinely implant multiple embryos to ensure successful outcomes during infertility treatment, which occasionally resulted in more than one simultaneous pregnancy.
However, as infertility treatment has improved and success rates have grown to an international average of between 45-50%, fertility specialists and global health advisories have begun to favour single embryo transfers during IVF treatments.
Read: Fertility doctors aim to lower rate of twin births
Dr Johannes van Waart, whose Wijnland Fertility Clinic in Cape Town is achieving success rates per single embryo of around 69%, explains; “Multiple pregnancies mean increased risk to both mother and children; risks ranging from inflated blood pressure and gestational diabetes in the mother , to the high likelihood of pre-eclampsia and premature birth. Our goal is to focus on single embryo success rates wherever possible. The technology available supports this approach and we have seen great results with the introduction of our Embryscope™ equipment, which adds much precision to the process.”
Image: The IVF process before implantation (Wijnland Fertility)
Unfortunately, some infertility patients are still of the mind that a multiple pregnancy is the ideal way to instantly grow a family; two or more babies for the price of one.
For some, the long wait for a baby also means that they are concerned about their age and rapidly diminishing chances of conceiving, even by means of IVF.
5 times more likely to deliver before 37 weeks
However, the costs of a multiple pregnancy are potentially very high. According to the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG), women are five times more likely to deliver before 37 weeks in a twin pregnancy compared with a single baby pregnancy.
Should birth complications or a lengthy stay in the incubator of a private hospital arise, parents could receive a medical bill of up to and over R1 million. The subsequent additional costs for extra carers, and the strain of buying two of everything, all adds up.
Read: Parents hesitant to tell kids about artificial insemination
Says Wijnland Fertility’s psychologist Lizanne van Waart, “Whilst patients may save by having only one infertility treatment initially, there are also substantial emotional costs to consider.The heartbreak of miscarriage (a factor that is escalated in multiple pregnancies) can be devastating to someone who has been struggling to conceive and is finally pregnant. For so many mothers the strain of caring for twins or triplets leads to depression and feelings of guilt as their dream of being a parent descends into the reality of a situation that is enormously demanding on all levels.”
Image: The embryoscope used in the process of IVF (Wijnland Fertility)
In many countries, it is illegal to implant more than one embryo. South African law says you can implant no more than three embryos per cycle.
Overseas patients believe a greater embryo count improves chances
Ironically, this means that some South African fertility specialists see a number of overseas patients who believe that a greater embryo count may lead to improved chances for success, the onus is on fertility specialists to guide patients to make informed decisions.
Read More:
Sperm length tied to fertility
White women more likely to seek fertility treatment
Would you believe how far people have gone to prevent pregnancy?
