More Hong Kong women to have multiple babies per pregnancy as use of fertility technology rises

Researchers warn of increased health risks such as premature delivery and low birth weight

PUBLISHED : Friday, 04 August, 2017, 8:02am
UPDATED : Friday, 04 August, 2017, 8:01am

Hong Kong is expected to see more women having not just twins but other multiple birth events, as fertility technology rises in popularity, according to the city’s first medical study of triplet pregnancies.

A total of 52 expectant mothers at Prince of Wales Hospital were carrying three babies in one go from 2008 to 2014, with 84 per cent having become pregnant through assisted reproductive technology, researchers said.

Half the triplet cases had to reduce the pregnancies to just twins or a single foetus in hopes of having healthier babies and minimising the risk of a miscarriage.

“Multiple pregnancy is an increasingly important problem in obstetrics as a result of the success of fertility procedures,” said researchers from the hospital’s department of obstetrics and gynaecology.

Carrying multiple babies – meaning three embryos or more – increases health risks such as premature birth, low birth weight, serious illness, and even stillbirth or death.

For those who carried triplets, their mean gestation period was 32.6 weeks, much shorter than the 35.2 weeks for twins and 39.6 weeks for single foetuses, the study found.

Multiple pregnancy is an increasingly important problem in obstetrics
Prince of Wales Hospital researchers

When fewer foetuses were carried, birth weight was higher on average and the need for intensive care fell.

Published in the Hong Kong Medical Journal on Friday, the study attributed the trend to the use of fertility services such as in vitro fertilisation. IVF has become more accessible and affordable in Hong Kong and mainland China as well as in Taiwan and Thailand.

Chinese University professor Li Tin-chiu said fertility doctors often transferred two or even three embryos fertilised in a lab into a woman’s uterus to increase the chance of at least one of them growing into a baby.

“But the downside of this is the risk of a multiple pregnancy,” said Li, who did not participate in the research. “This is why such practices should be controlled and avoided as much as possible.”

Li noted the number of multiple pregnancies accounted for about 11 per cent of all pregnancy cases at Prince of Wales Hospital, while hospitals in the UK tried to maintain the level below 15 per cent.

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The findings came as more local women opted for fertility treatment due to late marriage. The number of cases increased about twofold to more than 11,000 procedures from 2009 to 2015, according to the Council on Human Reproductive Technology in Hong Kong.

Since 2013, the council’s Code of Practice on reproductive technology has limited the number of embryos transferred per cycle to three.

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The study is the first to examine triplet babies in the city and concluded that the reduction of at least one foetus could help to reduce such risks.

Of the 52 cases, 26 saw fetal reduction performed, 22 were reduced to twins, and four cases were reduced to a single foetus.