Twins can be tempting for those considering assisted reproduction. For many couples, using in vitro fertilization to conceive two instead of one can be a way to make up for lost time, minimize the costs and hassle of multiple pregnancies and complete a family portrait they had always pictured with more than one child and the added adorableness of matching outfits.
But patients seldom acknowledge just how risky giving birth to twins can be.
The Canadian Fertility and Andrology Society ended its annual conference with a debate Sunday morning at Ottawa’s Westin Hotel on whether twins should be considered an undesirable outcome in IVF. The CFAS stance on the issue has long been decided: the aim of IVF is the birth of a healthy singleton. The aim of debate was not to reopen the position, but rather to discuss whether twin birth was undesirable or not. Surveys have shown the majority of couples considering IVF strongly prefer twin pregnancy over singletons.
“Twins are glamourized in popular press, and they’re cute,” said Moya Johnson, a representative with Birth Outcomes Registry Network (BORN) Ontario, which collects long-term fertility data. “What (the public) doesn’t see are the twins struggling with long-term impacts.”
The risk for long-term effects on IVF twins is not common, but when it does happens, it is devastating, Johnson said.
The issue, said Dr. Neal Mahutte, director of the Montreal Fertility Centre, is a dinosaur. A topic that still causes trouble even after the consensus has been reached.
“My opponent is very intelligent, educated, charming and some may even say dashing, but even if his presentation is convincing, even if he wins this debate, he has lost the argument.”
There are many issues patients, government and physicians must consider. How can the patient safely deliver a healthy child and how can the physician expose the patient to the least risk, both short term and long term? How can government fund or provide legislation that would favour the best fertility option rather than the cheapest one?