The Trouble With Twins

Everybody loves twins. They’re cute, they dress alike and they often have a fascinating emotional bond which makes them the subject of everyone’s wonder. Whenever twins are spotted with their parents, we all take a minute to stare and comment. But more than anybody, infertility patients love twins. After years of struggling trying to start a family, most of my patients love the prospect of an “instant family”. Surveys of infertile couples not only suggest that twins would be acceptable, but the majority of infertile couples indicate that twins would be “preferable” to a single baby.
These feelings are understandable and to a degree even logical. Fertility treatments are emotionally exhausting and often extremely expensive. Why not, many patients ask, just get it all done at once, have twins and get on with raising their family? Even patients who are not anxious to have twins balk at attempts to avoid them during IVF cycles. When I tell my patients that they have a decreased chance of pregnancy if I transfer one embryo instead of two – in order to avoid twins – they look at me like I’m a little crazy. Why would they want to decrease their chance of having a baby, especially if they are paying cash for their IVF cycle?
There are actually several good reasons to avoid twins and most couples are unaware of these! Twin pregnancies are associated with significant complications and risks for both the babies and mother which I will discuss below:

Premature Birth – A startling 65% of twins are born prematurely!
Low Birth Weight- Over half of twins weigh less than 5 1/2 pounds and 15% of twins are born with severe low birth weight – 3 1⁄2 pounds or less! This leads to a significant increase in lasting disabilities such as mental retardation, cerebral palsy, and hearing or vision loss.
Cesarean Section – Twins result in a very high chance of Cesarean Section. Many obstetricians are reluctant to deliver any twins vaginally. This increases recovery time, and also increases the risk for serious bleeding requiring blood transfusions and even occasional long term disabilities for mother.
Pre-eclampsia – Women with twins are twice as likely to develop this very serious complication of pregnancy. It can lead to dangerous, even life threatening consequences.
Financial Burden of Twins – It is estimated that twins cost society billions of dollars annually. These costs are attributed to the prolonged hospital stay frequently necessary to prevent premature delivery, the extended time in neonatal intensive care for the premature babies, and the cost of paying for the lifelong disabilities associated with severe pre-term birth of some twins.
As an infertility specialist, my primary goal is to help couples conceive healthy babies. It should be clear
that twins are not the best way to achieve this goal. The birth of a single healthy baby should be the
optimum goal of all fertility treatment. To this end, we have made significant changes in our practice to
minimize the birth of multiple gestations. These changes will be discussed thoroughly in future blogs.
Dr. Springer