Triplets

How many embryos should you transfer during fertility treatment? It has been the subject of much debate recently, and I find the argument used by some medical professionals that they can do nothing to prevent their patients opting for multiple embryo transfers is fascinating. Consultants are hardly known for their inability to tell their patients what is good for them, and yet when it comes to multiple embryo transfers many are suddenly unable to overrule patients making decisions that they know very well could lead to serious medical issues.

In the UK, the Human Fertilisation and Embryology Authority is monitoring the situation and setting targets for clinics to cut their multiple pregnancy rates. Successful clinics are reducing their multiple pregnancy rate without slashing their success rates by carefully selecting the patients who are most at risk of multiple pregnancy. Some other countries, such as Sweden and Belgium, have already taken these steps but others are way behind; for example, in the United States, many clinics transfer three or more embryos.

When you are trying to get pregnant, it is easy to imagine that triplets would be a marvellous outcome - three babies all at once, an instant family and no need for any more treatment. The reality is often very far from this perfect vision. The problem with fertility consultants is that their job stops with the positive pregnancy test. They don't see the babies born very prematurely and then spending weeks in special baby care units, they don't have to witness the long term health problems or the financial and emotional impact on the parents. Of course, it is not impossible to have healthy triplets, but the risks are high.

My views on this have been swayed by interviews I've done over the years with women who've faced huge problems after multiple embryo transfers. For my very first book, In Pursuit of Parenthood, I interviewed a woman who'd had three embryos transfered and who had been overjoyed when she discovered she was pregnant with triplets. She went into labour very early and gave birth to three tiny babies. She then had to live through a horrendous week, as her three children died one after another. "We'd gone into hospital happy, pregnant with three children, come out and we were arranging three funerals. It was as simple as that", she said. She went on to have a family after more fertility treatment, but having cope with such a terrible experience convinced her, and me, that it was far better to have embryos transfered one at a time.

If you are thinking of having treatment overseas, do ask the clinic about their policy on multiple embryo transfers. I spoke to someone a while ago who was planning to go to a particular clinic overseas because they would transfer five embryos. She assumed this meant that they had her best interests at heart as she felt they were willing to take a risk in order to help her get pregnant. This is far from the case. Clinics should not need to transfer five embryos and if they do, it shows a cavalier attitude to your health and your future children's. Remember, the risks associated with multiple birth are created by the decision to put back more embryos - it's an active choice to gamble with your own future children's health. Of course, multiple pregnancies don't always end in disaster, but I think for too long fertility patients have had to suffer because some fertility consultants have not been mindful of the problems they are creating for their patients.