Chances and Risks of IVF Twins: Can you have twins with ivf?

Chances of twins with IVF

The chance of obtaining identical twins with IVF is 1/250 (fraternal twins are 1/125) according to medical statistics, explained by Dr. Chun-I Lee. The American College of Obstetricians and Gynecologists (ACOG) also states that older mothers may release more than two eggs during their menstrual cycle, increasing the likelihood of conceiving multiples after the age of 35, but still lower compared to IVF. To enhance the success rate of pregnancy through IVF, multiple embryos are often transferred, resulting in a threefold higher chance of having twins or more compared to natural conception.

Can you choose to have twins with IVF?

Twin pregnancies are not always the result of IVF treatment. Several variables, including the mother's age and the presence of high-quality blastocysts, affect the ideal number of embryos to transfer. In accordance with the recommendations of the National Institute for Health and Care Excellence (NICE) in the UK, no more than two embryos should be transferred for women under the age of 39, and no more than two embryos should be transferred for women between the ages of 40 and 42. Today, the maximum number of embryos that can be implanted is typically capped at four in order to reduce the risks to both the pregnant woman and the fetus.
 

Recommended Number of Embryo Transfers for IVF

Age	Number of Embryo Transfers
<35	1-2
35-37	≤ 2
38-40	≤ 3
>41	≤ 4

Source: Taiwan Society of Reproductive Medicine Embryo Transfer Guidelines.

Risks of a twin pregnancy

The higher risks of a twin pregnancy, including illnesses and delivery complications, should be understood by a woman who successfully conceives twins through IVF at Lee Women's Hospital. Daily life necessitates special care and attention, and it is advised to seek medical attention right away if any of the following occur:

• Pregnancy-induced hypertension: There is a 20% risk of this condition in twin pregnancies. It is important to follow a healthy daily routine, eat foods that lower blood pressure, and regularly monitor blood pressure.
• Preterm birth: Pay attention to any abnormal discharge or bleeding. Bed rest, the administration of uterine contraction inhibitors, or the use of corticosteroids to promote fetal lung development are all options in such circumstances.
• Risk of abnormalities: Twin pregnancies have a higher risk of fetal abnormalities. High-level fetal ultrasound is recommended.
• Fetal malposition: Due to uterine expansion, the likelihood of malposition is higher in twin pregnancies. Most twin pregnancies result in cesarean sections, so mothers should be prepared in advance.
• Other complications: Twin pregnancies necessitate more frequent prenatal check-ups, and complications like incomplete cervical closure, preeclampsia, gestational diabetes, etc., should be closely monitored. If complications arise, follow the doctor's instructions for treatment.

In addition to regular care, daily caloric intake should be increased by at least 200–390 calories compared to a single pregnancy. Vitamin supplementation should also be doubled for nutrients like calcium, iron, and folic acid.

In general, twin pregnancies are riskier than single pregnancies. To ensure the well-being of both the mother and babies, it's essential to reduce physical activity in daily life, maintain a positive mindset and habits, and minimize anxiety. These are key factors for a safe and successful delivery.

Special case of IVF twins: Preterm birth at 17 weeks, one surviving fetus still in the womb

Miss Chen, a Taichung woman, underwent IVF treatment at Lee Women's Hospital and became pregnant with twins. However, at 17 weeks, she experienced a premature birth and lost one of the babies. Despite this, the medical team successfully saved the other baby within her womb through surgery. The probability of saving one of the twins in Taiwan is less than one in ten thousand.

With Mrs. Chen’s arms cradling her five-month-old daughter, the mother is filled with love and gratitude. This baby is the result of IVF and was supposed to be a twin, but Chen unexpectedly went into early labor at 17 weeks. Miss Chen: "It wasn't easy to come by. I just hope that she can grow up safely and healthy."

In Taiwan, the chance of saving one of the twins after a premature birth is less than one in ten thousand in clinical practice. The placenta typically begins to detach after one of the twins is born, according to Prof. Maw-Sheng Lee at Lee Women's Hospital. The placenta of the remaining fetus did not detach in this instance, so we considered our options for saving it. We sterilized the umbilical cord after cutting it, then we cleaned and reinserted the cord into the woman's vaginal canal.

The surviving fetus continued to thrive within the mother's womb, and at 27 weeks, a cesarean section was performed, successfully delivering a baby girl who weighed over a thousand grams. The success was attributed to the fact that the twins were fraternal (non-identical) twins.

Obstetrician Dr. Liao Jing-Ci from Lee Women's Hospital said that the probability of successfully keeping the second twin after the first twin from a twin pregnancy is very low. However, in this case, because Chen was doing well and she was a fraternal (non-identical) twin, there was still a chance to keep the second twin.

Miss Chen's daughter is now almost five months old, weighing 4800 grams, and her parents wish for her precious little life to continue thriving in the future.