CHESTER FERTILITY & ASSISTED CONCEPTION UNIT MULTIPLE BIRTH – A RISK OF TREATMENT Following the introduction of Assisted conception treatment there has been a dramatic incidence in the incidence of multiple pregnancy, most notably twins and triplets. Whilst multiple pregnancies are often seen by couples who have experienced fertility problems as a blessing, analysis of the birth data has shown that multiple pregnancies are associated with an increase in problems associated with pregnant and birth. The risk of miscarriage and other early pregnancy complications are increased, as are the risks of prematurity, fetal abnormality, bleeding in pregnancy and raised blood pressure. Twins and especially triplets are also more likely to be born with a disability as abnormalities and infant mortality are much increased in multiple birth babies than those were a single baby is born. Indeed although still a small figure, the mortality rate with triplets for each baby is approximately eight times that of a single baby. The dramatic problems of prematurity and mortality with triplet pregnancies were so great that legislation was introduced to reduce these risks. From the 1st April 2004 the Human Fertilisation and Embryology Authority (HFEA) has made it illegal within the United Kingdom to transfer more than 2 embryos in a cycle of IVF/ICSI. Whilst this will make triplet pregnancy very unlikely there is still a chance of twin pregnancy which is around 15-20% of couples who achieve a pregnancy, this figure is reduced with increasing female age. It is likely that within the next few years a move will be made to transfer only one embryo per cycle of treatment (at present this is associated with a significant reduction in your chances of pregnancy). However at present it is sensible to transfer two embryos if these are available. Since the introduction of a national 2 embryo transfer policy the risks of multiple births has dramatically reduced in association with IVF treatment, however multiple pregnancies including triplets can still occur from treatments such as ovulation induction with clomiphene gonadotrophins and IUI. For this reason this unit has taken steps to comply with national guidelines to reduce this risk. The policy of this unit is to closely monitor with ultrasound all cycles of ovulation induction and to cancel the cycle of treatment if more than 2 follicles/eggs are created. The doctors and nurses are happy to discuss any concerns or issues you may have with multiple births at any stage of treatment.