IVF just to reduce the chance of twins?

[SinkGirl]

DH and I have just had a big chat about the future, and whether we want any more children - this is a pressing issue for me because I’m 36, have endometriosis and adenomyosis and my only remaining option is a hysterectomy. The consultant has told me to just contact them when I want it as there’s no more they can do for me.

We have twin boys, 2.5 now, both have ASD and one has other disabilities / health issues. It’s tough going with all the appointments etc but they are wonderful lovely boys who I love to pieces.

The short version is that both of us would like another baby, and we are prepared that another baby may also have ASD. Our biggest concern is having twins. We could make space for a third child in our house and would just need a slightly bigger car, but if we had twins again we would need to move house, etc. I honestly am not sure my body could take another twin pregnancy, I have struggled with my health since then with ongoing deficiencies and various physical issues. I know I’m more likely to have twins after having one set (they’re non-identical).

If I could guarantee we would have a singleton then I think we would both go for it, but honestly the thought of another set of twins fills me with worry as the first year especially was so incredibly hard.

I was thinking of looking into IVF solely to minimise the chances of twins (although I’m guessing it’s still possible to end up with identical twins by this process, if it’s a late split but I’m not sure at what stage they’re inserted) - has anyone ever heard of / done this for this reason? We were lucky to conceive easily last time and recent hormone tests suggest things are functioning well at the moment.

I could not do selective reduction and obviously if we did get pregnant with twins then I would not consider ending the pregnancy - I would just like to avoid it if I can. I’ve googled but can’t find anything about this.

Wouldn’t IVF increase the chance of twins?

This seems like a conversation to have with a doctor who will know the probabilities.

I would imagine this wouldn’t be provided by the NHS for this reason though and it is (from what I’ve heard) invasive and unpleasant.

Pregnancy and birth always has a huge number of unknowns and to a certain extent I think we just have to accept that when we try and conceive.

I had dcda twins at 36, then a singleton pregnancy at 37.

I too was concerned at the 'risk' of more twins but my consultant assured me the chances were still very slim, although higher than the average joe.

I think it's just the nature of pregnancy, you never do truly know what you will (or won't) get.

I don't think ivf would reduce your chances by much tbh, to justify all that expense. You'd still have the 'risk' of identical as you said.

I understand why you're twitched, but the chances are still very low in the grand scheme of things. Good luck

Are your boys identical? Those are freaks of nature. Non-identical increase your risk of another twin pregnancy.

But I think you'd be crazy to do IVF for that reason unless you're very very rich.

I’ve had IVF and I read that it might actually increase the risk of identical twins, especially if you have a blastocyst transfer. But I’d definitely speak to a doctor about this.

I’ve just remembered that if you have a fertility treatment called IUI (intrauterine insemination), your ovarian follicles are monitored by ultrasound, partly to check that too many follicles don’t develop. I’ve never heard of anyone having IUI specifically to prevent a multiple pregnancy, but I wonder if follicle tracking could help you? It’s cheaper and much less invasive than IVF, but it also has a much lower success rate per cycle, so might not be practical.

It’s a huge amount to put yourself through in order to reduce a relatively small chance. Have you looked into what is involved in IVF? Dependent on age and egg quality factors, I think he chance of a successful pregnancy is still only about 30% per cycle and that is assuming a double embryo transfer. I believe the average chance of pregnancy is the same with a single embryo transfer but if averaged over 3 cycles. That’s 3 loads of downregulation/ovarian stimulation, egg collections, transfers, transvaginal scans etc etc. Not every couple has sufficient good quality embryos to freeze so you may have to start from scratch each time.
Don’t get me wrong IVF is wonderful and I wouldn’t have my children without it. But it’s bloody hard work too considering the alternative method!

I would talk to a doctor at a private fertility clinic but I expect all you need is an ultrasound each cycle

Non-identical twins are the result of 2 eggs being released at the same time. An ultrasound will show how many eggs are being released so you can just take precautions on months when more that 1 egg is released

Thanks everyone - to answer the questions above:

They are non-identical, so I do have an increased risk. Yes, I am aware of what fertility treatment involves - I was told I would need it to have a chance of conceiving, many years before I ever tried, so did lots of research. We started trying when we did so that we could qualify for an NHS cycle once we’d been trying for a year - did not expect to get pregnant right away and definitely did not expect twins.

I fully understand it wouldn’t be covered by the NHS and I wouldn’t expect it to be. IVF with a single transfer may increase the chance of identical twins, but from what I can tell that’s still lower than my chance of having non-identical twins now that I’ve had one set.

I realise this may sound extreme to some and it’s very easy to say that anything can happen when you have a baby. Of course that’s true but most people don’t expect twins or consider the possibility or already have experience of having twins and therefore the increased risk.

There’s some really helpful ideas here, thank you - I will look into those :)

Lamkin you’re so brave, I would have been petrified of having more twins so close together!

Even with no fertility issues their is a fair chance you would need several attempts to have a child. There is no guarantee of it working. It could end up being very expensive, time consuming and emotionally draining.