Twin pregnancy in surrogacy programs

Twin pregnancy is an exciting and somewhat common occurrence in IVF. During IVF treatment, multiple embryos may be implanted in the hopes of increasing the chances of success. This can result in the development of not one, but two healthy fetuses. While a twin pregnancy can come with its own set of challenges, it can also bring double the joy and love to expecting parents.

The number of embryos to transfer depends on several factors, including the age of the female partner, the quality of the embryos, and previous IVF attempts. Generally, the American Society for Reproductive Medicine recommends that younger women should have fewer embryos transferred compared to older women. For women under 35, it is recommended to transfer one or two embryos while women older than 40 may be advised to transfer three or more embryos. This is because older women have a lower chance of pregnancy and they may require additional embryos to increase their chances. The quality of the embryos is also a deciding factor. High-quality embryos have better chances of implantation, reducing the need for multiple embryo transfers. In cases where there are multiple high-quality embryos, it may be reasonable to consider transferring fewer than the maximum number of embryos allowed.

Previous IVF attempts can also influence the decision. Women who have had unsuccessful IVF cycles or multiple IVF attempts may be advised to transfer more embryos than what is recommended based on age. However, this should be done under close supervision by a fertility specialist to avoid the risks that come with multiple pregnancies.

It is important to remember that transferring more embryos than necessary, especially in younger women, poses a significant risk of multiple pregnancies which can lead to a variety of complications, including premature birth and low birth weight. Additionally, there are emotional and financial stresses associated with having twins or triplets that need to be considered before deciding how many embryos to transfer.

It is crucial to work with a fertility specialist to determine the optimal number of embryos for a successful pregnancy while minimizing the risk of complications.

Does the PGT/PGD/PGS increase the success rate in IVF?

Yes, preimplantation genetic testing (PGT) can increase the success rate of in vitro fertilization (IVF) procedures, according to studies. PGT involves analyzing the genetic material of embryos before they are implanted in the uterus to identify any chromosomal abnormalities or genetic disorders that could lead to embryo implantation failure, miscarriage, or a child born with a genetic disorder. By selecting embryos that are chromosomally normal and free of genetic disorders, PGT can improve the chances of a successful pregnancy and live birth following IVF. However, it is important to note that PGT is not necessary or appropriate for all IVF patients, and there are potential risks, including the possibility of embryo damage or misdiagnosis. Your doctor can help you determine if PGT is a good option for your IVF treatment.

What is a TTTS in twin pregnancy?

One possible medical complication that might happen in twin pregnancy is twin-to-twin transfusion syndrome (TTTS). This occurs when blood vessels in the shared placenta of identical twins are unequal, causing one twin to receive too much blood and the other to receive too little. This can result in serious health problems for both twins and requires close monitoring and medical intervention. Other potential complications include premature delivery, gestational diabetes, preeclampsia, and a higher risk of miscarriage. It is important for women pregnant with twins to receive regular prenatal care and follow the guidance of their healthcare provider to minimize the risks of such complications.

Here is a detailed list of possible medical complications that can occur in twin pregnancies:

1. Preterm delivery: Twin pregnancies are more likely to result in preterm delivery, which can lead to complications such as respiratory distress syndrome, intracranial hemorrhage, and necrotizing enterocolitis in infants.

2. Preeclampsia: This is a serious condition in which the mother's blood pressure rises significantly and protein levels are found in the urine. Preeclampsia can be life-threatening for both the mother and the babies.

3. Gestational diabetes: Twin pregnancies can increase the risk of developing gestational diabetes, which can lead to high birth weight and other complications.

4. Twin-to-twin transfusion syndrome (TTTS): This is a condition that occurs when there is an imbalance in the blood flow between the twins in utero. It can cause one twin to receive too much blood and the other too little, leading to serious complications for both twins.

5. Placenta previa: This condition occurs when the placenta covers the cervix, obstructing the birth canal. It can cause bleeding and lead to a higher risk of preterm delivery.

6. Intrauterine growth restriction (IUGR): This occurs when one or both of the twins are not growing at the expected rate, which can lead to a range of complications such as low birth weight, difficulty breathing, and neurological issues.

7. Cord entanglement: This can occur when the twins' umbilical cords become tangled or compressed, which can decrease blood flow and oxygen to one or both of the babies.

8. Congenital anomalies: Twins can be more likely to have congenital abnormalities and birth defects than singleton pregnancies.

9. Postpartum hemorrhage: Twin pregnancies can increase the risk of postpartum hemorrhage due to the extra strain on the mother's body during delivery.

It's important for women with twin pregnancies to receive regular prenatal care and monitoring from their healthcare providers to identify any potential complications early and manage them appropriately.

Having twin babies is a unique experience that can bring a lot of joy to parents. Here are some possible reasons why:

1. Double the love: When you have twin babies, you have two bundles of joy to love and care for. Every laugh, every smile, and every milestone is doubled, making the experience even more special.

2. Shared experiences: Twin babies often have a special bond with each other, and as parents, you get to witness and share that bond. Seeing your babies interact with each other, play together, and comfort each other can be heartwarming.

3. Being a part of a growing family: Having twin babies means that your family is growing! Watching your family expand and develop can be an exciting and fulfilling experience.

4. Unique challenges: While raising twins may present unique challenges, such as managing two different schedules, the rewards of being a parent to twins often outweigh the additional work.

For intended parents who are trying to decide whether to transfer a single embryo or two embryos during fertility treatment, it can be a difficult decision. My advice here would be to discuss it with your fertility specialist and weigh the pros and cons before making a decision. Your doctor will take various factors into consideration such as age, medical history, and the quality of the embryos to give you the best advice for your individual circumstances. Remember, it's not just about getting pregnant - it's about having a healthy pregnancy and a healthy baby. So, it's always better to be on the side of caution and prioritize the safety and health of everyone involved.