Multiple births

Reducing multiple births for a healthier and safer pregnancy

If you’re not yet familiar with the fertility treatment process, it’s worth reading the Treatment Journey and Blastocyst Culture and Transferpages before you read about multiple births, just so you’re familiar with some of the terminology.

One of the greatest risk in assisted fertility treatment is multiple pregnancy, which happens when one or more embryos successfully attach within the uterus. There is increased danger to the unborn babies and the mother. You can read more about the risks with multiple births below.

Our policy on multiple births

In 2009, the Human Fertilisation & Embryology Authority (HFEA) ordered fertility clinics to reduce their multiple birth rates from an average of 25% to 15% by 2012. The target figure is now 10% or below.

In line with the above HFEA guideline we would advise our patients under the age of 38 whose embryos have reached the blastocyst stage and are of good quality to seriously consider the transfer of only a single blastocyst. Data modelling from our database shows that patients who have blastocyst transfers have very good success rates. By restricting the number of embryos transferred you and your baby will be at substantially lower risk, without materially affecting the likelihood of becoming pregnant in the first place. We are quite happy to replace two embryos for patients who require a day 2-3 transfer as the risk of multiple birth is less than half compared to a day 5 (blastocyst) transfer.

What if you disagree with our policy?

We established our Multiple Birth Minimisation Strategy because our aim, above all else, is always to provide as safe and healthy a pregnancy as possible. However, we fully expect that some couples would, despite our recommendation, still insist on having two blastocysts transferred. This is understandable especially if they have had previous treatment failures. Under those circumstances the patient is required to sign a consent to the effect that she is aware of the risks. We wish to emphasise that ultimately the couple have the final say in the number of embryos they wish us to replace as long that it is within the HFEA Code of Practice i.e. maximum of two embryos for women under 40 and three embryos for women of 40 and over. We are always available to answer your questions fully and openly.

What are the risks associated with multiple pregnancies?

The risks associated with multiple pregnancy include increased risk of stillbirth, late miscarriage, premature delivery, neonatal death and disabilities such as cerebral palsy in the newborn. The probability that a baby will die before birth or within the first week of life is more than four times as much as for twins as a single baby and seven times greater for triplets.

There is also an increased risk of dangerous complications for the mother, such as high blood pressure, pre-eclampsia and gestational diabetes.

If you’re in any further doubt, we strongly recommend you visit www.oneatatime.org.uk for more information on the risks involved with multiple births.