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Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein. You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Get the Compare Your Your Quiz Your Summary This information is for women who are pregnant with three or more fetuses. It's also for their partners. Multifetal pregnancy reduction is a procedure to reduce the number of fetuses in a pregnancy—usually from three, four, or five fetuses to two. This may help the two fetuses survive and help you have a healthy pregnancy. This procedure is most often done in the first trimester or early in the second trimester. It can be done after genetic testing to find out if the fetuses have any problems. It's usually done through the belly. Using ultrasound as a guide, the doctor puts a needle into the uterus to the selected fetus or the umbilical cord. The doctor injects the fetus or the cord with a medicine that stops the heart. The dead embryo or fetus is absorbed by the mother's body. This is similar to what happens with vanishing twin syndrome. Reduced risk for mother. The procedure reduces the mother's risk of problems. These risks include gestational diabetes, preeclampsia, and anemia. These risks increase with each added fetus. Reduced risk for infants. The procedure may improve your chances of carrying your pregnancy longer and your chances of delivering one or more healthy babies. Carrying triplets or more increases the risk of miscarriage, stillbirth, premature birth, and disability. Reduced stress related to infant care. Caring for three or more babies can be stressful, especially if any of them has health problems. Reduced cost of caring for multiples. The hospital care for three or more infants can be expensive. Because multiple babies have an increased chance of premature birth and illnesses, they are cared for in a neonatal intensive care unit (NICU). Caring for the babies at home also could be costly. After they come home, premature babies often need medicines, medical equipment and supplies, and extra doctor visits. The risks of reducing the number of fetuses include: Some couples choose to implant fewer embryos to reduce the chance of a pregnancy of triplets or more, rather than consider having this procedure. Compare What is usually involved? What are the benefits? What are the risks and side effects? These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. When my husband and I learned we were expecting three babies, we were thrilled. But along with that news we heard about the risks for them and me. I'm already at risk for pregnancy problems, since I've had gestational diabetes before. So we decided to have a multifetal pregnancy reduction. What convinced me was the knowledge that the miscarriage rate is higher for triplet pregnancy than it is for the twins after the procedure. And it went well for us. We took the risk, and the babies and I are doing well. Pam, age 37 Because of my age, our fertility doctor encouraged us to have four embryos transferred for my in vitro. We were surprised that all of them took and were worried about the risks. After talking for a few days about having a multifetal pregnancy reduction, my husband and I decided not to have one. We were more comfortable with letting nature take its course. And it did—by the second trimester, two were gone, and I was carrying twins. Maya, age 43 I just couldn't bring myself to have a multifetal pregnancy reduction, even though my doctor told me that my pregnancy was high-risk. I'll never know whether it would have gone better if I'd had the procedure, but trying to carry the four babies didn't go well. One died after birth, and now we have the challenge of raising triplets, one of which is disabled. Joelle, age 35 Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to have fetal reduction Reasons to carry triplets or more I want to increase the chance of having two healthy babies. I want to try to have all my babies. I want to lower my chance of having a problem like preeclampsia. I may not have any problems. But if I do, my doctor and I can decide about treatment then. My ethical and spiritual values would allow me to have fetal reduction. My ethical and spiritual values wouldn't allow me to have fetal reduction. I don't think I can take care of a child with a disability. I can take care of a child with a disability. I can't afford to raise three or more children. I have the resources to raise several children. My other important reasons: My other important reasons: Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Fetal reduction Having triplets or more Check the facts Decide what's next Certainty 1. How sure do you feel right now about your decision? Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. This information is for women who are pregnant with three or more fetuses. It's also for their partners. Multifetal pregnancy reduction is a procedure to reduce the number of fetuses in a pregnancy—usually from three, four, or five fetuses to two. This may help the two fetuses survive and help you have a healthy pregnancy. This procedure is most often done in the first trimester or early in the second trimester. It can be done after genetic testing to find out if the fetuses have any problems. It's usually done through the belly. Using ultrasound as a guide, the doctor puts a needle into the uterus to the selected fetus or the umbilical cord. The doctor injects the fetus or the cord with a medicine that stops the heart. The dead embryo or fetus is absorbed by the mother's body. This is similar to what happens with vanishing twin syndrome. Reduced risk for mother. The procedure reduces the mother's risk of problems. These risks include gestational diabetes, preeclampsia, and anemia. These risks increase with each added fetus. Reduced risk for infants. The procedure may improve your chances of carrying your pregnancy longer and your chances of delivering one or more healthy babies. Carrying triplets or more increases the risk of miscarriage, stillbirth, premature birth, and disability. Reduced stress related to infant care. Caring for three or more babies can be stressful, especially if any of them has health problems. Reduced cost of caring for multiples. The hospital care for three or more infants can be expensive. Because multiple babies have an increased chance of premature birth and illnesses, they are cared for in a neonatal intensive care unit (NICU). Caring for the babies at home also could be costly. After they come home, premature babies often need medicines, medical equipment and supplies, and extra doctor visits. The risks of reducing the number of fetuses include: Some couples choose to implant fewer embryos to reduce the chance of a pregnancy of triplets or more, rather than consider having this procedure. These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. "When my husband and I learned we were expecting three babies, we were thrilled. But along with that news we heard about the risks for them and me. I'm already at risk for pregnancy problems, since I've had gestational diabetes before. So we decided to have a multifetal pregnancy reduction. What convinced me was the knowledge that the miscarriage rate is higher for triplet pregnancy than it is for the twins after the procedure. And it went well for us. We took the risk, and the babies and I are doing well." — Pam, age 37 "Because of my age, our fertility doctor encouraged us to have four embryos transferred for my in vitro. We were surprised that all of them took and were worried about the risks. After talking for a few days about having a multifetal pregnancy reduction, my husband and I decided not to have one. We were more comfortable with letting nature take its course. And it did—by the second trimester, two were gone, and I was carrying twins." — Maya, age 43 "I just couldn't bring myself to have a multifetal pregnancy reduction, even though my doctor told me that my pregnancy was high-risk. I'll never know whether it would have gone better if I'd had the procedure, but trying to carry the four babies didn't go well. One died after birth, and now we have the challenge of raising triplets, one of which is disabled." — Joelle, age 35 Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to have fetal reduction Reasons to carry triplets or more I want to increase the chance of having two healthy babies. I want to try to have all my babies. I want to lower my chance of having a problem like preeclampsia. I may not have any problems. But if I do, my doctor and I can decide about treatment then. My ethical and spiritual values would allow me to have fetal reduction. My ethical and spiritual values wouldn't allow me to have fetal reduction. I don't think I can take care of a child with a disability. I can take care of a child with a disability. I can't afford to raise three or more children. I have the resources to raise several children. My other important reasons: My other important reasons: Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Fetal reduction Having triplets or more 1.
Does a fetal reduction lower the chance that your remaining baby or babies will have a disability? 2.
Do both choices have emotional side effects? 1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? 1.
How sure do you feel right now about your decision? 2.
Check what you need to do before you make this decision. Current as of: November 27, 2023 Author: Healthwise Staff Clinical Review BoardMultiple Pregnancy: Should I Consider a Multifetal Pregnancy Reduction?
Multiple Pregnancy: Should I Consider a Multifetal Pregnancy Reduction?
1
Facts2
Options3
Feelings4
Decision5
Yourself6
Get the facts
Your options
Key points to remember
What is multifetal pregnancy reduction?
What are the benefits of a multifetal pregnancy reduction?
What are the risks of multifetal pregnancy reduction?
Compare your options
Personal stories about multifetal pregnancy reduction
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?
Your Summary
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits
Author Healthwise Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.Multiple Pregnancy: Should I Consider a Multifetal Pregnancy Reduction?
1. Get the Facts
Your options
Key points to remember
What is multifetal pregnancy reduction?
What are the benefits of a multifetal pregnancy reduction?
What are the risks of multifetal pregnancy reduction?
2. Compare your options
Have fetal reduction Carry three or more fetuses What is usually involved? What are the benefits? What are the risks and side effects? Personal stories
Personal stories about multifetal pregnancy reduction
3. What matters most to you?
4. Where are you leaning now?
5. What else do you need to make your decision?
Check the facts
Decide what's next
Certainty
By Healthwise Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.