Attitudes of IVF/ICSI-twin mothers towards twins and single embryo transfer

Our aim was to study attitudes towards twins and single embryo transfer (SET) among IVF/ICSI-twin mothers with 3 to 4-year old children.

A national survey was conducted by questionnaire (n = 1769). The study population consisted of IVF/ICSI-twin mothers (n = 266), and the two control groups of IVF/ICSI-singleton mothers (n = 764) and non-IVF/ICSI-twin mothers (n = 739), all giving birth in Denmark in 1997. The overall response rate was 81%.

More IVF/ICSI-twin mothers (84.7%) preferred twins as their first child compared with IVF/ICSI-singleton mothers (62.3%) and non-IVF twin mothers (60.0%). The IVF/ICSI-twin mothers had a significantly higher wish for twins (OR = 4.4, 95% CI 2.8-6.9) compared with the non-IVF/ICSI-twin mothers. Though relatively few IVF/ICSI-twin mothers (23.4%) and IVF/ICSI-singleton mothers (17.3%) agreed to SET, delivery of a child with very low birth weight (VLBW) (<1500 g) was predictive of high acceptance of SET (OR = 2.9, 95% CI 1.2-6.9).

Our study suggests that IVF/ICSI-twin mothers have a greater wish for twins compared with non-IVF/ICSI-twin mothers. Despite the fact that only a quarter of IVF/ICSI mothers agreed to SET, delivery of a child with VLBW and hence high morbidity was predictive of high acceptance of SET. The implementation of elective SET requires extensive counselling of the infertile couples and legislation including strict selection criteria may also be used to facilitate this process.