Do I Have to Carry Twins as a Surrogate?

One question frequently asked by prospective surrogates is, “Do I have to carry twins as a surrogate?” It’s a common misconception that surrogates have to agree to carry multiples, and in fact Brownstone Surrogacy strongly advises against it. In this blog post, we’ll dive into why we recommend single embryo transfers (SET) for the surrogate’s, intended parents’, and baby’s sake!

1. The Risks of Carrying Twins

While carrying twins may be a viable option for some surrogates, it is essential to understand the associated risks. With a twin pregnancy comes increased risks and complications such as preterm labor, gestational diabetes, preeclampsia, anemia, and organ dysfunction. Additionally, studies have found that double embryo transfers lead to triplet pregnancies in more than 1% of cases, even further increasing these risks. Furthermore, the rate of miscarriages with twins is double that of single pregnancies. So while it initially might seem that multiples have the same risks as a singleton, studies show otherwise. 

At Brownstone, we want the best, healthiest outcomes for our surrogates, intended parents, and surrobabies, and that’s why we always ensure that surrogates and intended parents are fully educated on the risks of double embryo transfers (DET).

2. Delivering Twins

When we’re talking about multiples, it is crucial to acknowledge the higher risk of labor complications. Again, statistics show increased risk of complications during delivery. For instance, the likelihood of delivering via cesarean section is approximately 75% with twins, and more than half of twins are born at a low birth weight. Moreover, about one-third of twins require neonatal intensive care unit (NICU) admission. Not only can these complications cause emotional and financial stress, but they can also lead to lifelong health issues for the babies. 

3. Two Single Embryo Transfers vs. One Double Embryo Transfer

We get the appeal of having twins: they may have a special relationship with one another, if intended parents want two kids then having twins might seem like a great way to cut down costs and quicken the process. But the truth is, a double embryo transfer does not always result in twins. Rather, it is more likely to have two children through two separate single embryo transfers rather than through a double embryo transfer. Furthermore, intended parents could be saving money with a double embryo transfer and twin pregnancy, but due to the associated risks involved, there is also a chance that they could actually spend more on medical bills.

4. Single Embryo Splits to Twins

For the potential risks that we’ve listed above, we discourage double embryo transfers. However, it is important to note that a single embryo transfer may occasionally split and result in twins. This split happens about 1%-2% of the time. Due to this possibility, Brownstone surrogates and intended parents will have discussions prior to the embryo questions. These discussions will address topics of fetal reduction when medically safe and advisable, wherein the number of embryos is selectively reduced to a singleton. 

Most of the time, surrogates are happy to carry twins in these circumstances and the intended parents are excited once the initial shock subsides. The most important thing is that all parties are on the same page, and that’s why we have a plan in place should a single embryo transfer split into multiples.

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