Advances in Assisted Reproductive Technologies (ART), particularly In Vitro Fertilization (IVF), have significantly improved the chances of conception for many couples. However, IVF may result in multifetal pregnancies, including triplets and higher-order multiples, which are associated with increased maternal and fetal risks. In such high-risk pregnancies, fetal reduction may be considered as a management option to improve pregnancy outcomes and reduce potential complications.
What Is Embryo Reduction?
Embryo Reduction, also called Selective Reduction, is a medical procedure used to decrease the number of fetuses in a multifetal pregnancy.
Why Is Embryo Reduction Important
Carrying multiple fetuses places a heavy burden on the mother’s body. Embryo reduction is not about convenience; it is a medical decision made for safety and survival.
Benefits for the mother:
- Reduced chances of premature labor
- Lower risk of miscarriage
- Lower risk of pregnancy-induced high blood pressure
- Better control of gestational diabetes
- Reduced stress on heart, lungs, and circulation
Benefits for the babies:
- Higher birth weight
- Lower chance of needing ventilator support
- Lower risk of neurological problems
- Better long-term development
When Is Embryo Reduction Done?
The procedure is typically done between the 12th and 13th week of pregnancy,
Timing is crucial because performing the procedure at the right stage minimizes risks to the continuing pregnancy.
How Is the Procedure Done?
- Ultrasound guidance: A doctor uses real-time ultrasound imaging to view the fetuses and select the targeted embryo or fetus.
- Needle placement: A thin needle is guided through the mother’s abdomen (transabdominal) or through the vagina (transvaginal) into the designated gestational sac.
- Medication injection: A medication, usually potassium chloride, is injected into the fetal heart or thorax to stop its cardiac activity.
- Natural reabsorption: Over the following weeks, the non-surviving fetal tissue is naturally reabsorbed by the mother’s body
What Are the Risks?
- Mild cramping or spotting
- Risk of infection
- Premature rupture of membranes
- Miscarriage of the entire pregnancy (about 4–5 percent risk, depending on the case)
