There is a way out of this challenge, but it is one that is seldom discussed among mommies-to-be: selective reduction. In cases of high multiple pregnancies, doctors will often recommend selective reduction for purely medical reasons. Early in the pregnancy, one or more of the fetuses are aborted from within the womb to increase the likelihood that the remaining babies and the mother will survive and thrive.
There are numerous health concerns to both mother and infants associated with carrying multiples. Thus for decades obstetricians have offered the option of reducing down to twins, which tend to have safer outcomes.
This procedure can only be done with fraternal twins, as identical twins share a placenta and cannot easily be separated. Fertility message boards such as fertilitythoughts. New York City obstetrician and leading expert in selective reduction, Dr. Mark Evans, says that reductions from twins to a single fetus make up about 10 percent of the reductions he performs in his office, and that number is slowly increasing. Evans wrote the recommendations on selective reductions 25 years ago, but at time, he advocated for reductions only down to twins, barring extenuating circumstances.
So parents often wanted two or more kids ultimately anyway," says Evans. But in , Evans published a paper that overturned his past recommendations, arguing instead for the safety of reducing to singletons, even if the original pregnancy was only twins.
We now know that twins are not twice the risk of singletons, they are more like four times the risk. Singleton pregnancies that started as twins are still difficult and risky for the fetus and the mother — aborting the other fetus does not change that. But if the woman accepts the burdens and risks of the pregnancy and offers her body to be used by one of the fetuses, she should offer her body to be used by the other fetus as well.
It is not easy to accept this view because if the woman cannot or does not want to raise two children, it would imply that she should adopt out the other child rather than have it killed in the womb. Separating twins at birth seems morally disturbing, but perhaps not as disturbing as the other solutions to the problem.
The views and opinions expressed on this site are solely those of the original authors. They do not necessarily represent the views of BMJ and should not be used to replace medical advice. Please see our full website terms and conditions. Skip to content. Post navigation Previous post. A ml syringe is linked to the cannula and sudden suction is applied.
The embryo is aspirated into the cannula with the amniotic fluid, while the trophoblast is left in place. To date, this method has been applied in 15 cases of multiple pregnancy resulting from ovarian hyperstimulations.
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