Octos and Quints, Is this what we want?!
Recently, a couple from Oro Valley (outside of Tucson, Arizona) delivered a set of quintuplets in Phoenix. 5 babies at once! Seems like nothing compared to the octuplets delivered in California in January. No Dr. Phil, no paparazzi, just boring, run of the mill quintuplets, not enough for a reality TV show or diapers for life…..To the parents who have been enduring this challenge (the other option for them was to “reduce” the pregnancy by killing off some of the fetuses, is that really an OPTION?) we wish them only the best and hope that their children will overcome the statistics and that their families will thrive. But was it reasonable to for them to face this challenge because they wanted a child and had to go through fertility therapy to acheive that?
At the Reproductive Health Center, this has prompted us to let you know how we feel about multiple births and what our responsibilities are to our patients. As strong as the desire for a child can be, it is well documented that multiple pregnancies and births are dangerous for both the children and parents. Multiple gestations are an adverse outcome of assisted reproductive technology (ART) and ovulation induction therapies and a responsible medical team should act ethicallyby offering the highest probability of pregnancy while minimizing the chance of delivering multiple babies.
In our practice, we will only transfer two blastocysts to women under the age of 40. Women under the age of 35 are strongly encouraged to have single embryo transfers. Our last set of triplets (the highest number gestation from our IVF program) was conceived in 2006. This prompted our current internal guidelines for embryo transfer. We are striving toward single embryo transfer in all of our transfers.
Our position is:
- That we have a responsibility to our patients, their current children and those yet to be born to keep their lives whole and healthy.
- We are aware that fertility therapy associated multiple gestation constitutes a major physical, psychological and financial challenge to couples, their children and society as a whole.
- Fertility therapy associated multiple gestation remains a challenge nationwide. Preventing the occurrence of fertility related triplets in our practice was our initial goal. Reducing the incidence of twin gestations is our current goal.
- Further progress toward reducing the incidence of IVF assoicated twin pregnancies requires patient education and laboratory improvements. We are currently establishing systems for improved means of assessing embryo quality and uterine cavity receptivity to reduce the percentage of twin pregnancies without affecting the overall pregnancy rate. We are educating our patients about the risks of twin gestations so that they can make responsible choices about how many embryos they choose to transfer.
- We think that the quality of an IVF program should be measured not only by its overall pregnancy rate, but by its ability to maximize the singleton birth rate.
As we strive to help our patients be fruitful and multiply, our goal is to do it ONE gestation at a time…….
