Nearly half of all babies born with fertility help are multiples, so many that it is being called a "twin epidemic." Fertility doctors are working to reduce the number of multiple births and the medical complications that come along with very high risk pregnancies.
It is another start to the day in the Landry home in Lake Charles with adorable twins, Jackson and John Paul. Their parents, Anna and Justin, tried for two years to get pregnant with no success.
When in vitro fertilization became the last option, this couple knew it carried a 35 percent chance of having twins. "I was fine with having twins," said Anna, "I knew that it was a possibility."
Dr. John Storment with Fertility and Women's Health Center of Louisiana says there is a science behind the decision over how many fertilized eggs, or embryos, to implant during an IVF procedure. "It depends on the patient's age, the quality of the embryos and the will and desires of the patient," he said.
Lab techniques to create and grow these embryos have dramatically improved. Dr. Storment says that means fewer embryos can be used to achieve a pregnancy outcome. "There are guidelines from the American Society for Reproductive Medicine that in good prognosis patients, I transfer only one or two," said Dr. Storment, "I actually have to fill out a form if I transfer three to explain why I transferred more than the standard."
The high price of in vitro fertilization has many couples only able to afford one shot at pregnancy. In some cases, they ask a doctor to implant at least two embryos and boost their odds. "If you save up that much money and somebody says you have a 40 percent chance that one of the two will make it, financially you have one shot," said Justin.
Dr. Storment says many couples will ask for two or three embryos because of the higher odds that they will become pregnant, even if multiples are involved. "There's a sense of desperation and they say they will take their chances," said Dr. Storment, "I hear it all the time, 'We want twins, we want twins.' I don't want twins."
Twins are more likely to be born premature, affecting their vision, lungs and GI tract.
The Landry twins beat major odds to survive a pregnancy that Justin and Anna were told had only a ten percent chance of success after a medical scare at 21 weeks. "I was devastated," said Anna, "and I thought things were not going well and we have strong chance of losing them."
The next few months were spent on bed rest to save the twins. Amazingly, they were born healthy at 36.5 weeks.
The Landrys have eight frozen embryos leftover and are considering going through IVF again, but with a different plan. "Because of the complications with carrying the twins, I would be safe about it and only implant one if we tried to do it again," said Anna.
One embryo at a time, one baby at a time - that is the hope that Dr. Storment has for the future of fertility treatments. "What I anticipate in the next five years is that we get good enough that transferring one embryo gives you a fifty percent chance of having a baby and so you do not run the risk of having twins and everybody's happy," he said.
The cost for in vitro fertilization is about $15,000. An embryo transfer from leftover embryos is about $2,500. Clinics in New Jersey and Utah have participated in IVF studies and found that delivery rates for one embryo transfer versus two embryo transfers were roughly the same, with about 60 percent of couples conceiving.