Multiple pregnancies

Multiple pregnancies--pregnancies with twins or more--are a risk of both in vitro fertilization and fertility medications. Younger women are more likely to have multiple pregnancies than older women. For example, if an older women produces three eggs when she's taking fertility medications (or has three embryos transferred during IVF), chances are that all three will not fertilize and develop successfully. However, a younger woman who takes fertility medications and produces three eggs may well become pregnant with triplets.

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There are always risks in pregnancy; women are at risk of developing high blood pressure and gestational diabetes, for example. With twins, the risks of these and other complications goes up. This includes the risk of cesarean section, premature labor, and premature delivery. With triplets, the risks are even higher. The more prematurely a baby is born, the higher the risk for health and developmental problems. While a singleton pregnancy averages 39 to 40 weeks, twins are usually born at about 36 weeks, triplets at 32 weeks, and quads about 30 weeks. Babies from triplet pregnancies and higher often have serious problems.

In cases where a woman becomes pregnant with triplets or more, she may choose to have a reduction performed at the end of the first trimester. This reduces the risks to the mother and babies. However, in about 3 to 5 percent of reductions, the whole pregnancy will be miscarried. For women who are opposed to reduction, the doctors may be more conservative with treatment, choosing to give lower doses of fertility medications or transfer fewer embryos in IVF.