In recent years, many couples have successfully conceived twins through in vitro fertilization (IVF). IVF is a process in which sperm and eggs are retrieved from the body, fertilized in a laboratory, and the resulting embryos are transferred into the uterus. To increase the chances of a successful pregnancy, a doctor may transfer more than one embryo during treatment after careful consultation with the patient — resulting in a higher likelihood of twin or multiple pregnancies compared to natural conception.
The number of embryos transferred depends on various factors, including the maternal age and embryo quality. Given that multiple pregnancies carry risks for both the mother and the fetuses, a fine balance between maintaining a high success rate and minimizing the chance of multiple pregnancies is essential.
To strike this balance, the Taiwan Society for Reproductive Medicine recommends the following guidelines for the number of embryos to be transferred:
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Under 35 years old: 1–2 embryos
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Ages 35–37: Up to 2 embryos
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Ages 38–40: Up to 3 embryos
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Over 41 years old: Up to 4 embryos
For patients eligible for Taiwan's government-funded IVF subsidy program, compliance with the embryo transfer limits is required. The regulations are as follows:
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Age 35 and under: A maximum of 1 embryo may be transferred per treatment cycle.
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Ages 36–44: A maximum of 2 embryos may be transferred per treatment cycle.
If the number of embryos transferred exceeds these limits, the treatment will not qualify for the IVF subsidy.
Are IVF Twin Pregnancies Riskier Than Singleton Pregnancies? A Must-Read for Moms Hoping for Two!
Compared to singleton pregnancies, twin pregnancies carry a higher risk of complications such as preterm birth, abnormal fetal positioning, and congenital anomalies. It is important to take extra care during daily prenatal routines and to listen to your body throughout the process. If you notice any unusual symptoms or discomfort, please seek medical attention promptly.
Common risks associated with IVF twin pregnancies include:
Preterm Birth
Twin pregnancies place greater demands on the body than singleton pregnancies. To accommodate two fetuses at once, the uterine muscles can become overstretched, increasing physical strain and raising the risk of preterm labor.
The primary goal in managing a twin pregnancy is to prolong gestation as safely as possible. Strategies to help reduce this risk include getting adequate rest, using tocolytics (medications that help prevent early contractions) when necessary, and receiving corticosteroid injections to support fetal lung development — helping to ensure the babies' lungs are ready by the time of delivery.
Gestational Hypertension and Diabetes
Women with a pre-existing history of hypertension or diabetes, those who experience excessive weight gain during pregnancy, or those with lifestyle habits such as smoking or drinking are at higher risk of developing gestational hypertension or gestational diabetes.
These conditions can negatively affect fetal development, increase the risk of preterm birth, and impact the mother's overall health. Regular prenatal check-ups, early detection, and proper management are especially important in IVF twin pregnancies, where the body is under considerably more physical demand.
Abnormal Fetal Position (Malpresentation)
With two fetuses sharing limited space in the uterus, abnormal fetal positioning is more likely to occur in twin pregnancies. One or both babies may not settle into the ideal head-down position needed for a vaginal delivery.
In such cases, doctors often recommend a cesarean section (C-section) to avoid the risks of prolonged labor or difficult delivery, keeping both mother and babies safe.
Fetal Anomalies
The risk of fetal anomalies is slightly higher in twin pregnancies than in singleton pregnancies. In addition to routine ultrasound scans, a detailed (Level II) ultrasound is recommended to more thoroughly assess fetal development and screen for any structural abnormalities.
Increased Risk of Other Complications
Twin pregnancies are also associated with a higher risk of other complications, including:
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Cervical insufficiency
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Placental abruption
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Preeclampsia
Regular prenatal check-ups and following your doctor's guidance closely are the best ways to catch any issues early and manage them promptly.
Is Vaginal Delivery Possible for IVF Twin Pregnancies?
Vaginal delivery is possible for IVF twin pregnancies, as long as both fetuses are in a favorable position, all indicators are within normal range, and the mother is in good overall health. However, since twin pregnancies are more prone to malpresentation, this can lead to prolonged labor and put considerable physical strain on the mother. For these reasons, doctors often recommend a cesarean section (C-section) as the safer choice for twin pregnancies.
Your Most Trusted Partner for Fertility Care — TFC Taipei Fertility Center
At TFC Taipei Fertility Center, we offer comprehensive, integrative care that nurtures both body and mind — including reproductive medicine, traditional Chinese medicine, psychological counseling, and nutritional support. Our team of experienced physicians and specialists is dedicated to crafting a personalized treatment plan tailored to every individual's unique needs.
Recognized for clinical excellence, TFC has built a strong international reputation and is trusted by patients from around the world.
To ensure a seamless experience, we provide a dedicated consultation app for a more private and comfortable visit. With our one-stop fertility service model, same-day blood test results help reduce waiting times and keep your treatment moving forward — efficiently and without compromise.
Our spacious waiting area is designed with your comfort in mind, offering light refreshments, blankets, and charging stations to help you feel at ease every step of the way.