Octomom Nadya Suleman’s story is one of the most famous – and extreme – examples of multiple pregnancies resulting from in vitro fertilization, but experts say high-order multiple births (three or more babies in one birth) are now less likely thanks to better technology and medicine.

“Nowadays, having high order multiples from in vitro fertilization is very uncommon, and the reason is the advent of single embryo transfer,” explains Pavna Brahma, M.D., a reproductive endocrinologist at Piedmont Atlanta Hospital. “Embryologists today are really great at being able to culture embryos for longer outside of the uterus.”

This process allows physicians to optimize the selection of embryos and choose those that are most likely to implant.

“By doing this, we’ve been able to limit the embryos we transfer back to patients,” she says.

Cryopreservation, the ability to freeze unused embryos, has also reduced the occurrence of high-order multiple births. The thaw rate for frozen embryos is now 95 percent thanks to vitrification, an instantaneous flash-freeze of the eggs that limits crystal formation and protects the integrity of the DNA.

 “While we used to have a ‘use it or lose it’ mentality, where if we made four embryos, we felt as if we had to replace them all, we now are leaning strongly toward single embryo transfer with cryopreservation of the remaining embryos to use them for future siblings or future attempts at pregnancy,” Dr. Brahma says.

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