The Risks of Multiple Births

One of the biggest challenges of fertility treatment is the
occurrence of multiple births.  I have
twins, and I’m happy, but, multiple pregnancies are high risk pregnancies. And
there is a hierarchy of risk. After the joyous realization that you’re
pregnant, you await the first of many ultrasounds. It will reveal whether the
twins share one placenta or each have their own. Sharing is more high risk for
the twins; vascular pressure can become unbalanced, damaging, even killing one
twin. Or they can share one amniotic sack. This is very dangerous, because
there is a high possibility of strangulation as the unborn twins move about in
the long months of pregnancy. As this information comes to you from your doctor
(if your doctor even knows this, and/or tells you), you feel like you are in a
game of  “Russian roulette”, and each
complicating factor is like another bullet being slipped into the cylinder-
nothing you can do about it, and each factor potentially lethal.

And for nine months you live with the risk, knowing that
some tiny factor beyond your control, some small “butterfly effect” can end the
life of one or both of the unborn children you have sacrificed so much,
already, to be carrying. Unless you live in one of Canada’s major cities, you
will be travelling long distances often, to have your pregnancy monitored. In
my case, every two weeks I travelled two and a half hours to Sudbury, had a
half hour ultrasound, spent fifteen minutes with the OB (who was not a
specialist), then drove two and a half hours back home. Later in the pregnancy,
the trips were once a week  this is
expensive and time consuming.

Like most couples in Ontario who have to pay for IVF, I chose
to have multiple embryos transferred.  I
had four embryos placed back into my uterus. 
FOUR!  That’s a lot.  I could’ve had quadruplets, or more.  But, I had twins.  Identical (monozygotic) twins.  Which means that only one embryo survived;
and split.

Obviously, I thought that was a brilliant move at the
time.  We had spent all the money we
had.  They told us our embryos were of
low quality.  So, we were easily
convinced to have four “poor quality” embryos placed.

If IVF had been funded, would I have agreed to that?  Probably. I really, really wanted to be
pregnant.  However, if IVF is funded, there will be regulations
requiring only one embryo transfer.  Is
that a good thing?  Well, it seems like
it is.

The reality is that multiple births have higher risks; the
higher the number of multiples, the higher the risk.  Here are some statistics on the risks:

Multiple births in Canada are on the rise: birth of twins has risen 35% (per 100,000
successful pregnancies) between 1974-1990.
The incidence of triplets has increased almost 300% and quadruplets over 400% between 1974-1990.