What do I need to worry about with a multiple pregnancy?

Revised 2014

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Women who take fertility medicines to get pregnant have a higher chance of having more than one fetus in a pregnancy. Fetus is the term for developing humans from 11 weeks of pregnancy until birth. A multiple pregnancy or multiple gestation may have 2 fetuses (twin pregnancy), 3 fetuses (triplet pregnancy), or other (high-order multiple pregnancy). Each added fetus raises the chances of having a risky pregnancy and can be dangerous for both the mom and babies. Early (preterm) birth is one of the most common problems.

What are some problems with having a multiple pregnancy?

Pregnancy loss

The more fetuses there are in the womb, the more likely it is that the pregnancy will end in miscarriage, premature delivery, or stillbirth. Sometimes one or more of the fetuses will no longer be seen with ultrasound, called vanishing twin syndrome. In fact, 1 out of 3 pregnancies with more than one fetus will naturally reduce its number very early in pregnancy.

Problems for the babies

Many problems are linked to the babies being born early (prematurity). Premature babies can have problems with their lungs, stomach, and bowels, and even die. Some require long stays in the neonatal intensive care unit. Prematurity can also cause problems with bleeding in the brain, which can lead to problems with the baby’s nervous system and development. Prematurity can cause problems with movement and mental retardation, inlcuding cerebral palsy. Some problems may not be noticed until the children are older.

Problems for the mother

The risk of pregnancy complications goes up with each fetus in the womb. Some women can develop high blood pressure in pregnancy, called preeclampsia or toxemia of pregnancy. This can be dangerous and it can cause preterm birth, seizures, and, in extreme cases, death of the mother. Gestational diabetes (problems with high blood sugar) is more likely with a multiple pregnancy. In the early stages of a multiple pregnancy can also have more nausea, vomiting, and constipation than a woman carrying one baby. Problems with bleeding before and after the delivery are also more common.

What can I do if I have a multiple pregnancy?

If you are carrying more than one fetus, talk with your doctor and partner about your options. Multiple pregnancy often means specialized obstetric care, especially for triplet and other high-order multiples. Many complications cannot be prevented, but getting good care is important to reduce your risks. Some women may choose to have a procedure called multifetal pregnancy reduction. This can be used to reduce the number of fetuses to a smaller number to increase the chances of having just one or two healthy child(ren). Women with serious health problems may consider this necessary to make the pregnancy less risky.
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Multiple Births or Multiple Gestation

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Multiple Pregnancy and Multiple Births: Understanding the Risks for Mothers and Babies

Research shows that women carrying twins and triplets are at greater risk for complications than women carrying one baby. Watch Video
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Multiple Pregnancy

Multiple Pregnancy is a pregnancy that includes more than one fetus and is much more common today than in the past. As attractive and efficient as a multiple pregnancy may sound, there can be significant risks associated with carrying, delivering, and raising multiple children. The goal is one healthy baby at a time. Watch Video
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Oral medicines for inducing ovulation

Some women may need medicines to help them ovulate (release eggs). View the fact sheet
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What do I need to worry about with a multiple pregnancy?

Women who take fertility medicines to get pregnant have a higher chance of having more than one fetus in a pregnancy. VIew the fact sheet
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Fertility Drugs And The Risk of Multiple Births

Infertility treatments that cause multiple eggs to develop make it more likely that you will become pregnant with twins, triplets, or more. This is called multiple gestation. View the Fact Sheet
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Side effects of injectable fertility drugs (gonadotropins)

Gonadotropins are fertility medications given by injection that contain follicle-stimulating hormone (FSH) alone or combined with luteinizing hormone (LH). View the fact sheet
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Challenges of Parenting Multiples

There are many psychological, social, and economic issues associated with multiple pregnancies. View the Fact Sheet
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Multiple Births or Multiple Gestation Infographics

ASRM has prepared infographics to illustrate the subject of Multiple Births or Multiple Gestation better. View the infographics

Fact Sheets/Booklets

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Menopausal Transition (Perimenopause): What Is It?

The menopausal transition (perimenopause) is the period that links a woman’s reproductive (childbearing) years and menopause.
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Stress and infertility

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