Before You Ask Me for Twins, Go Visit a NICU

“Doctor, can you give us twins? One boy, one girl, and we’ll never have to go through this again.” If you have asked yourself this, you are not alone. So many couples struggling with infertility find themselves wishing for a shortcut: two babies in one go, family complete, no more injections, no more endless waiting rooms or rollercoaster cycles. It feels practical, almost efficient. Who wouldn’t want double the joy after all this pain?

The Unseen Reality Behind Twin Pregnancies

But here’s what almost nobody tells you: asking for twins during IVF is not just a numbers game. It is a decision that can change everything, in ways you might not expect. If you have never stepped into a neonatal intensive care unit (NICU), it is almost impossible to imagine what the risk of twins really looks like. I have seen it up close, and I wish every patient who cheerfully asks for “just put back two embryos, doctor” could see it too, just for a few minutes.

Inside a NICU, you will see rows of incubators. Babies that could fit in your palm, covered in wires and tape, their skin almost see-through. The soft beeping of monitors is constant. Parents sit for hours beside these plastic boxes, reaching in through portholes to touch a tiny hand, sometimes for weeks or months at a stretch. It is a world few wish to know, and yet, for many twins, especially those conceived through IVF, this is where life begins.

A twin pregnancy is not just a “two-for-one” offer. It is a different, riskier journey for both mother and babies.

Why Twins Are Not Just Double the Happiness

Here is a hard truth most clinics avoid spelling out. Many of the babies in Indian NICUs are not there because of unpredictable accidents or rare diseases. They are there because two embryos were transferred, and both implanted. In medical terms, this is called “iatrogenic”, complications caused by the very treatment meant to help you.

While twins make up about 3 percent of all births, they take up a far larger share of NICU beds. Not because of bad luck, but because twin pregnancies almost always carry higher risks:

• Twins are usually born early (on average at 35 weeks, compared to 39 weeks for singletons).
• Premature birth means lungs, brains, and other organs may not be ready for the outside world.
• Risks are much higher for breathing issues, feeding problems, brain bleeds, vision problems, and developmental delays.
• Mothers face higher rates of pre-eclampsia, gestational diabetes, excessive bleeding, and unplanned caesareans.

We do not talk about this enough: the “joy” of twins can come with months of hospital anxiety, medical bills, and sometimes lifelong challenges, not just twice the nappies and feeding bottles.

The Myth of Double the Chance

So many couples believe transferring two embryos means a higher chance of a baby, or at least better value for the money spent. IVF is expensive, after all. It feels logical: two embryos, double the odds, and maybe you get lucky with twins and never have to walk through the clinic door again.

But reality is different. If you have a good quality embryo (a blastocyst), transferring just one and freezing the rest for later actually gives you almost the same overall chance of taking home a healthy baby as transferring two at once. In fact, international guidelines now recommend elective single embryo transfer whenever possible, to protect both mothers and babies.

The cost of a premature twin delivery, with weeks in the NICU, can easily exceed the cost of another IVF cycle. And that’s just the financial toll. There is also the emotional cost: the worry, the guilt, the exhaustion, and sometimes heartbreak if things do not go as planned.

What Good Fertility Clinics Really Aim For

At Malpani Infertility Clinic, our job is not to get you a positive pregnancy test as quickly as possible. Our real goal is to help you bring home a healthy baby, and to help you make decisions with your eyes open, fully aware of the risks and benefits.

We do not shy away from the uncomfortable truths. Many clinics still transfer two embryos because it bumps up their statistics, and because it’s far easier to say yes than to have the difficult conversation about NICU realities. But that is not fair to you. You deserve the full picture: what will maximize your chance of a healthy baby, and what could put your family through avoidable pain.

You are not doubling your joy by choosing twins. You are doubling your embryos and multiplying your risk.

How to Make the Decision That’s Right for You

Before you decide, here is what I suggest: if you are considering asking for twins, go visit a NICU in a major hospital. Not just photos online. Ask to spend ten minutes there. See the reality that statistics cannot capture. Listen to the beeps, watch the parents, feel the weight of that room. Then come back and tell us what you want. Most couples change their minds after that experience.

• Single embryo transfer is safest for most women under 35 with good quality embryos.
• Frozen embryo transfers (FET) allow you to use your other embryos later, with almost identical success rates.
• If your embryos are not top quality or you are older, your doctor may discuss the balance of risks for your unique case.

At Malpani Infertility Clinic, we believe in giving you the information others might avoid, so you can make your own informed decision. Our commitment is to your well-being and your baby’s health, not just a quick result. If you want to talk through your options with someone who will give you the honest facts, we are here for you.

Still feeling uncertain or want to discuss your personal situation with someone who truly puts your well-being first? Speak to an expert fertility advisor at Malpani Infertility Clinic for honest, compassionate guidance, from understanding your choices to making the best decision for your family’s future.