Should You Purposely Get Pregnant With Twins or Triplets?

Pregnant Woman Sitting On Porch Reading about the risks of IVF twins and triplets
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Have you ever thought about purposefully trying to conceive twins or triplets and wonder if that's a good idea? Maybe you have been trying to conceive for years, and you have struggled to pay for your in vitro fertilization (IVF) treatments. Now, your doctor is suggesting a single embryo transfer...but you're thinking it might be a better idea to try for multiples.

Or, perhaps, your doctor has treated you with fertility drugs like Clomid or gonadotropins. Ultrasound has shown multiple follicles developing, and your doctor has asked you not to have sex because the risk of conceiving multiples is high, and they want to avoid that possibility.

This might be confusing, as getting pregnant with twins or triplets is a wonderful, happy surprise for many families. However, there are good reasons for caution.

Overview

The idea of getting pregnant with twins or triplets may appeal to you. You may like the idea of creating a bigger family in one pregnancy and possibly avoiding paying again for costly fertility treatments. However, while it can (and often does) turn out positively, carrying multiple babies at once significantly raises the risk of serious pregnancy complications, for both you and your future babies.

In addition to the increased risk of unhealthy physical outcomes, there are mental health risks and financial consequences to consider as well. Of course, however many babies you end up with will be embraced with love, but know that the strain (physically, emotionally, and practically) of taking care of multiples (particularly if they have special needs) and managing a household of many children is well documented.

Electively pursuing a multiple pregnancy is not recommended by most doctors and key medical associations, including the American Society for Reproductive Medicine (ASRM), which points out that over 60% of multiples are born early, while just 10% of singletons come before their due dates. Also, while the average birth weight of singletons is 7.3 pounds, twins and triplets weigh in at an average of 5.1 and 3.7 pounds, respectively.

Risks of Twins and Triplets for the Mother

A multiple pregnancy is more likely to result in pregnancy complications like pre-eclampsia and gestational diabetes. Also, the risk of miscarriage and preterm labor is significantly increased, the treatment of which can include hospital stays and/or bed rest.

Women who have multiple pregnancies usually need to gain more weight during pregnancy and are more likely to deliver by cesarean section.

It's difficult to think about, but consider the fact that you may get pregnant with more than one...but not get to take them all home. In fact, according to the ASRM, in triplet (or higher) pregnancies, the rate of one or more of the fetuses "disappearing" (called vanishing twin syndrome) is approximately 40%. In twin pregnancies, fetal loss occurs in up to 20% of cases.

When this happens in the first trimester, the remaining fetuses usually continue to safely develop, but this is not always the case—and coping with a "vanished" twin can be hard emotionally.

Another factor to consider: If your babies are born prematurely, you might not get to take them home right away, and they are more likely to have lasting complications. Depending on how premature they are, they may need to stay in the hospital for weeks or even months. Having a baby in the neonatal intensive care until (NICU) can be a highly stressful, overwhelming situation for a new mother and father.

In fact, rates of postpartum depression increase with multiple pregnancies. Twins and triplets require much more work than caring for one baby. While, of course, there is certainly the immense, magical joy that comes along with having any number of babies, don't discount the stress multiples may place on your family after you bring them home.

Family and friends may offer their help at first, but that often doesn't last forever. Eventually, you may be on your own and it's important to be realistic about how much work caring for one baby is—let alone two, three, or more at a time.

Risks to the Baby

Besides the increased risk of miscarriage and stillbirth, the biggest risk to your babies is premature birth. According to the March of Dimes, more than 50% of twins are born prematurely. The statistics are even worse for triplets—more than 90% of triplets are born prematurely. For higher-order pregnancies, like quadruplets or more, virtually all babies are born early.

While doctors today are better able to care for babies born prematurely, especially those born before 34 weeks, a premature baby still has a notably higher risk of:

  • Birth defects
  • Cerebral palsy
  • Developmental delays
  • General health problems
  • Growth problems
  • Learning disabilities
  • Low birth weight
  • Neonatal death (death in the first 28 days of life)

These are chronic problems that may have a big impact on your baby's lives. Premature babies may also be born with serious complications to their lungs, stomach, or intestines, as these organs often don't have enough time to fully and properly develop in the womb.

If you are or do get pregnant with multiples, seek support from your family, friends, and the larger community to get the help you'll need, because, as noted above, raising lots of kids is a big job, often stressful, and expensive. Counseling may also be useful as you adjust to parenting multiples.

A Word From Verywell

Know that you can still get pregnant with twins even if you transfer just one embryo with IVF, as your risk of identical twins is higher than average with this procedure. But also know that many multiple pregnancies end successfully.

So, while it's not recommended to pursue multiple pregnancy intentionally, if you do get pregnant with twins or triplets (and many people do with and without assisted reproductive technologies), don't panic. Close prenatal monitoring provided by a doctor specializing in high-risk pregnancies will greatly increase the likelihood of a positive outcome.

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  1. American Society for Reproductive Medicine. Multiple pregnancy: Twins, triplets, and high order multiples (booklet). 2012.

  2. March of Dimes. Being pregnant with twins, triplets, and other multiples. Published March 2017.