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New Tool to Predict IVF Patients' Chance of Having Twins

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by Leigh Ann Woodruff, June 5, 2012

Being pregnant with twins is riskier than a singleton birth, no question. There are many more complications for both mother and babies. However, many couples undergoing in vitro fertilization (IVF) want to transfer more embryos in order to ensure they have a pregnancy and birth. But if you knew you were very likely to get pregnant with twins, would you still ask your fertility doctor to transfer more than one embryo?

A paper published in Fertility and Sterility reports the results of an advanced statistical method — which takes into account such factors as total motile sperm and Day 3 FSH levels — that can reliably predict an individual IVF patient's chance of conceiving multiples before the embryo transfer. The authors applied an advanced statistical prediction analysis to 2,413 double embryo transfer cycles at Boston IVF that resulted in live births from 2000 to 2009. They found that individual IVF patients have different risks of multiple birth probabilities, ranging from 11.8 percent to 54.8 percent. In more than half the patients, the rates were significantly different from probabilities based solely on age.

"Today, IVF patients and their physicians struggle with the choice of how many embryos to transfer," says Mylene Yao, M.D., one of the article's authorsand co-founder and CEO of Los Altos, Ca.-based Univfy Inc., developers of prognostic technology for fertility patients. "There is a general concern that transferring only one embryo can compromise the chance of pregnancy, and transferring even two embryos may raise the risks of multiple birth and associated obstetrical and neonatal complications. Personalized predictions of multiple birth risks enable patients and physicians to make safer and more informed embryo transfer decisions, while aiming to reduce incidence of unplanned multiple births."

Women who become pregnant with twins are at much higher risk for pregnancy complications, including:

  • Premature birth
  • Low birthweight
  • Cesarean section
  • Twin-Twin Transfusion Syndrome (TTTS) in which a connection between the two babies' blood vessels in the placenta causes one baby to get too much blood flow and the other too little
  • Pre-eclampsia, a combination of high blood pressure, protein in the urine and generalized swelling
  • Gestational diabetes

The researcher's statistical model showed more than 100 percent improvement in predictive power over the age-based prognostication, which is commonly used today. The variables that most affected the chance of multiple birth included:

  • age
  • number of four-cell embryos
  • total motile sperm
  • serum peak estradiol level
  • Day 3 FSH levels

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