Forget "Octo Mom." The hot debate among in vitro fertilization (IVF) patients and their doctors isn't about having lots of babies at once. It's about trying for twins. Patients who want twins point to the high costs of IVF, their ticking biological clocks, and their frustration and exhaustion from lengthy fertility struggles. They ask, why not have two at a time?
Leslie Glass says she did want twins when she turned to IVF.
Life with Twins
When a couple undergoing IVF finds out they are expecting twins, it's the start of a lifelong roller-coaster ride. These four moms, including Amanda Gifford, pictured here with Ethan and Abigail, talk candidly about their pregnancies and their lives today.
Amanda Gifford, "It's a lot of heartache," but "I still wouldn't do anything differently."
Her reasoning: "It was so expensive and I knew that this would probably be it for us," Glass tells WebMD. "If we get twins, all the better, because whether we had twins or one, it's still $22,000. So if this is it, then let's just complete the family."
But doctors say it's risky.
Compared to having one baby, twins and other multiples are more likely to have serious -- and even life-threatening -- health problems, including preterm birth, low birth weight, and birth defects.
"[Patients] are so focused on getting pregnant in any way, shape, or form that the concerns with multiples are secondary," Alan Peaceman, MD, professor and chief of maternal-fetal medicine at Northwestern University Feinberg School of Medicine, tells WebMD.
"Sometimes, they just don't understand how bad 'bad' can be," Peaceman says.
And just like that, one of the most intimate decisions an adult can make -- how many children to have -- becomes a medical, ethical, and personal minefield that can pit patient against doctor. Here are the pros and cons from each side of the debate.
IVF Cost, Insurance a Factor
It's rare for IVF patients to bluntly request twins, and few ask for triplets or more, but many mention a desire for twins, IVF doctors tell WebMD.
That happens "all the time," says Mark Perloe, MD, medical director of Georgia Reproductive Specialists in Atlanta.
Suheil Muasher, MD, medical director of the Muasher Center for Fertility and IVF in Fairfax, Va., agrees.
"A good number of my patients would kind of joke about it and say, 'We would like to have twins,'" says Muasher. "Most of the time they don't demand it, but it is something desirable for them."
Perloe and Muasher practice in states where insurance companies aren't required to cover IVF. That leaves patients to shoulder IVF costs themselves.
Those costs can add up quickly.
The average U.S. cost for one IVF cycle is about $12,500, says Elizabeth Ginsburg, MD, president of the Society for Assisted Reproductive Technology (SART) and the medical director of assisted reproductive technologies at Brigham and Women's Hospital in Boston.
"For some people, they can afford it once and that's it," Ginsburg tells WebMD. But IVF doesn't always succeed in the first cycle.
The Glasses spent $22,000 out of their own pockets for three rounds of IVF.
"We're still paying for them," Glass says of her twin daughters. "We didn't go in there and say, 'We'd like twins.' It was, 'We can't get pregnant, we need your help, this is the only way we can do it.'"
Even in states where insurance covers IVF, some patients still want twins. Ginsburg hears that from women nearing the end of their childbearing years, people who think twins are "cute," and people who want two kids but only one pregnancy. "They feel like it's just very efficient that way," Ginsburg says.