During the infancy years of In Vitro Fertilization, doctors
transfered as many embryos as possible with the hope that at least one of them
implants into the uterine lining, resulting in a viable pregnancy. Intended parents are well aware that they could
go from not even having one child at home to a sudden full house in only one
Let’s not forget that the
goal of infertility treatments is to produce “a” healthy pregnancy and
delivery, and of course “a” healthy baby.
Nowadays, the cost and the tremendous challenge of infertility
treatments cause intended parents using Assisted Reproductive Technology to
desire multiple pregnancies. After all,
with one pregnancy they can achieve a complete family. Furthermore, the success
rate of these methods has increased recently due to new technologies. Doctors can even determine the gender of the
embryos before transfer and we are able to see not only twins but more specifically
a female and a male being transferred and both implanting, resulting a complete
family in only one attempt at pregnancy.
The American Society of Reproductive Medicine no longer recommends
multiple embryo transfers unless there is a medical necessity. This is especially true in the case of
donated eggs where doctors can select the highest quality embryo before
transfer. Multiple pregnancies carry higher risks and costs during pregnancy,
at the time of delivery, and even through the babies’ lifetime.
It is a known fact that multiple babies tend to be smaller and be
born sooner than singletons. As a
result, the notion that we can get “two for the price of one” is not entirely
Here are some facts to consider when contemplating a multiple
transfer to your surrogate.
Intended parents should be aware that multiple babies have a
higher chance of needing to stay at the Neonatal Intensive Care Unit (NICU), resulting
in not only a huge expense but also a heartbreaking experience. As a whole, the
births of multiple babies can be up to four times more expensive than the birth
of a singleton; and twelve times more for triplets.
Many of our intended parents come from South America and
Europe. These parents have to take into
consideration the cost of insurance for their babies as well as the costs of
extending their leaves from work while “on vacation” and the cost of the
obligated “vacation” as well.
Raising multiple children at once is also more expensive than
raising one child at a time. When children are raised non-simultaneously, the
second child can re-use many of the items that were purchased for the first
child. With multiple children at once, parents
must purchase each and every item in multiples, and at the same time.
All pregnancies have risks but these risks are raised
exponentially with multiple pregnancies.
Premature births usually go hand in hand with low birth weight (which
can result in many developmental neurological problems such as cerebral palsy,
neural-tube defects like spina bifida, and vision and hearing loss).
Also, your surrogate will most likely require a C-section. Obstetricians prefer planned Cesarean
sections because, as they say, once the first baby is delivered, the second
baby can turn, requiring an emergency C-section along with a myriad of new complications
in the delivery.
During the pregnancy, your surrogate will require multiple visits
to the perinatologist who, together with the obstetrician, will be watchful for
pre-eclempsia, gestational diabetes.
It is important, here, to compare the statistics. Only 9% of singleton deliveries have a risk
of low birth weight compared to a 57% chance in the case of multiples. Only 14% of singleton pregnancies have a risk
of being premature compared to 65% in the case of multiples. Needless to say, the cost of raising children
with developmental disabilities is not even comparable to that of raising
There is always the chance of selective reduction where the
Obstetrician eliminates one or more of the embryos during the early stages of
the pregnancy. This procedure has its own risks and drawbacks. For starters, the
complete pregnancy could be lost. Not to mention the fact that parents would be
aborting a completely healthy fetus, an emotional decision for both the
gestational surrogate and the parents.
As an agency, we often find that women who are willing to become
surrogates get discouraged when they find out that they will have two embryos
transferred. Candidates for surrogacy
visit chat rooms and learn of the risks, and sometimes request single embryo
transfers only. Moreover, during the
psychological evaluations, the mental health professional will discuss multiple
embryo transfer, selective reduction and abortion extensively. Surrogates are hard to find and intended parents
are anxious to get started with their journey.
Besides, even if the candidate for gestational surrogacy is
considered healthy by the reproductive endocrinologist, he might not clear her
for a multiple pregnancy.
Implanting a single embryo is the best way to avoid all the
complications described above. By the
time the couple has consulted with their Reproductive Endocrinologist and had
their mandatory visit to the psychologist, they have already been informed of
the risks of multiple pregnancy. The
American Society for Reproductive Medicine has created a website with videos
and other educational tools to help parents make an informed decision. Please visit reproductibefacts.org and read
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