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Multiple Births: Why So Many?

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Did you know that in the United States twin births have gone up 70 percent since 1980? Or that triplet births have gone up 400 percent since 1980? According to the U.S. National Center for Health Statistics, those are the facts; similar increases in multiple births are also being seen throughout Europe and in other developed countries. One might wonder just why this has happened, and if there are ramifications to these numbers rising so dramatically.

  Factors Contributing to Multiple Births

  Multiple Births and Infertility Treatments

  Risks of Multiple Births

Factors Contributing to Multiple Births

The incredible change in the numbers of multiple births is generally thought to be due to two factors that are often related: older age at conception and infertility treatments. Twins are far more common in women over the age of 35, and as the age of the mother increases beyond 35, the chance of having higher order multiples (three or more babies) increases as well. The number of births to women in their 40s has gone up 70 percent since 1981, and the number of women giving birth in their 50s has increased 18 percent since 2006.

Multiple Births and Infertility Treatments

For the majority of women conceiving at an older age, infertility treatments are responsible for their multiple births. In fact, more than 40 percent of the increased number of multiple births since 1980 are linked to infertility treatments. Less than 20 percent of triplets are conceived without infertility intervention. Everyone has heard of the occasional woman who has five, six, seven, or eight babies in one pregnancy, but these cases are exceedingly rare.

There are two main categories of infertility treatment. In both, the woman is given a drug to help her ovaries produce eggs. The first category is called intrauterine insemination (IUI). When the eggs are ready, the couple is instructed to have sex, or the doctor injects sperm into the woman, and everyone hopes for fertilization. In some cases very large numbers of eggs are produced, and the health care provider might call off the procedure in order to reduce the chance of higher order multiples, but many times using IUI results in multiple births.

In the other category of treatment, which is called in vitro fertilization (IVF), the drugs again force the ovaries to produce eggs, but when the eggs are ready the doctor removes them from the woman and fertilizes them with sperm in the laboratory. After a few days the doctor then implants one or more fertilized eggs into the woman. In this type of treatment, it is possible to limit the number of embryos. The professional organizations for infertility suggest that not more than two or three embryos be implanted, in order to reduce complications to those babies. Many countries have strict restrictions on how many embryos can be implanted. These restrictions are designed to avoid higher order multiple births and devastating health consequences.

Risks of Multiple Births

Being pregnant with twins, triplets, or higher order multiples can lead to many complications, chief among them preterm birth. Some women who are seeking pregnancy through infertility treatments may express a desire to have several babies at once in order to complete their family, but attempting to have multiples is not the best plan. When a woman has multiple births, both she and her babies are at higher risk for many health problems. If you have questions about multiples or multiple births, talk to your health care provider.


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