Fetal Reduction is considered when a patient is carrying a multiple pregnancy; fetal reduction is a much debated topic in the world of IVF and is a result of the number of embryos transferred at the end of an IVF cycle.
The debate is bought on by how many embryos to transfer for patients desperate for a twin pregnancy and patients who have had many unsuccessful IVF Cycles and feel that the more embryos transferred the more chance they will achieve a pregnancy. This is not the case as the more embryos transferred may not only lead to a multiple pregnancy e.g. triplets, quads etc. but also to complications in carrying a pregnancy.
This is why there is an ongoing debate to only transfer one embryo in many countries including Turkey.
The advantage of a single embryo Transfer
- There is evidence to suggest that a single embryo transfer shows there is less risk of anomalies to the fetus but many would argue this fact.
- A single embryo transfer also reduces the risk of Preeclampsia and any other complications that can be found during pregnancy i.e. diabetes.
- Also the risk of premature labour is reduced.The Advantages of transferring more than one embryo and when it becomes necessary;
- Repeated failed IVF cycles.
- Women who have suffered many miscarriages.
- Women who have a less chance of success of implantation and also falling pregnant.
The below statistics are based on patients who have undergone previous IVF treatment at different clinics before attending our clinic:
- 20% have tried Egg Donation before
- 63% of patients have tried at least one previous IVF cycles
- 57% have undergone one IVF cycle
- 54% have tried two IVF Cycles
- 40% have tried three IVF Cycles
- 2% have tried previous Sperm Donation Cycles.
The statistics above indicate that more than 50% of patients have undergone many IVF cycles so the option to transfer two embryos seems more viable than only one.
Transferring 2 embryos does carry a risk of triplets when both embryos embed, this is very rare and it’s called a ‘monozygotic pregnancy’, when one egg splits into 2 and twins develop in one sac and the second embryo develops into another sac.
When we are faced with situations like these, there is always the option to reduce the pregnancy in order to prevent complications. Reduction of an embryo carries a high risk that patients need to be counseled on, and only an experienced doctor should carry out the procedure.
This is carried out between the 11th-12th weeks of pregnancy and is usually done through the stomach or vagina with the aid of an ultrasound. The process is very complex where firstly they measure the fetuses and choose the fetus that shows slow development. The fetal heart cavity is then identified and with a needle Potassium is injected to stop the development. After an abortion it’s not necessary as the fetus slowly shrinks over time and disappears. There is always a risk that all fetuses can be lost through this procedure and it is a technique that is used as a last resort.