How is multiple pregnancy reduction in IVF done?

This article is professionally consulted by Master, Doctor Nguyen Thi Cam Van - IVF Lab Doctor - Reproductive Support Center - Vinmec Times City International Hospital. The doctor has experience and strength in performing specialized techniques of assisted reproduction in the IVF lab.

Having multiples increases the risk of morbidity and mortality for both the mother and her unborn baby, and the more pregnancies that occur, the greater the risk.
Babies born with multiples face a higher rate of complications, including: Premature birth, cerebral palsy, cognitive impairments, language delays, and behavioral difficulties , chronic lung disease, underdevelopment, and death.

The risk of miscarriage for pregnant women with four pregnancies is 25%, with triplets is 15%, with twins is 8%. Compared with singleton pregnancies, multiple pregnancies are associated with a five-fold higher risk of stillbirth and a seven-fold increased risk of neonatal death, stemming from complications of preterm birth. Besides, the association between the risk of cerebral palsy in twin pregnancies and triplets increased by 4.9 and 12.7 times, respectively, compared with singleton pregnancies.
Complications for pregnant women in the case of multiple pregnancies include: high blood pressure, preeclampsia, gestational diabetes and postpartum bleeding.
In addition, being pregnant with multiples will also affect other social aspects, such as: Financial problems, quality of life as well as future parenting problems. The medical costs of carrying twins can increase fourfold, and carrying triplets can even increase tenfold, not to mention the future medical costs for the children.
Even being a parent with multiple children is stressful, can cause depression and impairs quality of life.

Multiple pregnancy poses risks to both the mother and the fetus, so reducing multiples is a serious issue in the implementation of IVF. The most common way to reduce multiple pregnancies in IVF is to reduce the number of embryos during embryo transfer or to minimize pregnancy.

Reducing multiples is an issue that is directly related to ethical and legal issues, so before implementing it, it is necessary to consider a number of aspects as follows: Selective multiple pregnancy reduction, multiple pregnancy reduction when the sex of the fetus is known. pregnancy and reducing multiples to singleton
3.1 Selective multiple pregnancy reduction Selective multiple pregnancy reduction means reduction of multiple pregnancies but the choice of which pregnancy to keep will be based on technical considerations, such as ease of implementation. most present, least complications,...
Usually, the pregnancy chosen to keep will be based on the health status. Before coming to a final decision, pregnant women will be carried out ultrasound and genetic evaluation to make judgments about the risk of abnormalities or pathologies of the fetus, from which the pregnant woman will be consulted based on actual situation as well as what measures are currently available. After knowing all the information, pregnant women will make their final choice that is best for themselves.
3.2 Reducing multiples when the sex of the fetus is known Before proceeding to reduce the multiple pregnancy, some women may have performed amniocentesis or chorionic villus sampling, to know the sex of the fetus. It is not allowed to disclose the sex of the fetus to the pregnant woman and her family.
3.3 Reducing multiples to singletons For some women, complete reduction of multiples to singletons is an inevitable choice or a subjective decision, to suit a variety of reasons. reasons ranging from health problems to financial, social, or even just plain desires. In any case, the doctor will provide adequate and timely necessary information to advise the pregnant woman in a thorough, unbiased way, so that the pregnant woman fully understands her condition. and consider making a final decision.
Ideally, when the signs of multiple pregnancy have been identified, pregnant women need to be careful and should register for maternity programs to choose the package to be monitored and examined most closely.
Currently, Vinmec International General Hospital is implementing a Package Maternity Program to support pregnant women from before - during and after giving birth. When registering for a maternity package, pregnant women will be cared for by qualified doctors, all information will be regularly informed before the scheduled date of examination, ultrasound, and testing.

Article referenced source: acog.org