Selective Reduction in Multiple Pregnancies

Most women who undergo an ART procedure are thrilled and can successfully carry a twin pregnancy. However, pregnancies with triplets and especially a higher number of fetuses carry increased risks of birth defects and premature delivery. Risks for the mother include greater chance of high blood pressure, gestational diabetes, uterine bleeding, and complications associated with a C-section delivery.

For these reasons, most fertility clinics limit the number of embryos transferred into the woman's uterus to two or three. Sometimes three or more babies implant and grow; in this circumstance, the parents and the fertility specialist are faced with a heart-wrenching decision. Do they continue the pregnancy as is and accept the many increased risks to mother and babies? Or do they decide to destroy one or more of the fetuses in an effort to save the others?

Selective reduction is the process of destroying one or more fetuses with the purpose of reducing the pregnancy, usually to twins. In such a case, selective reduction could be ethically acceptable, because it is aimed at optimizing the quality of life after birth. Even so, those against selective reduction argue that it is ethically wrong and note that it may even, though rarely, result in a loss of the entire pregnancy (2 to 7 percent of cases).

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