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Playing catch up: Doctor, I need twins now please ...

Health & Science
 Some women will require counselling before getting their children because it is a high-risk pregnancy and they need to be well prepared. [iStockphoto]

Women who have delayed raising a family are now opting for technology to deliver twins and make up for the lost time.

The delay over education and pursuing careers, among other reasons, has seen a decrease in fertility rates over the last two decades.

Dr Wanjiru Ndegwa, an Obstetrician/Gynaecologist and Fertility specialist, lists other reasons for decreased fertility as including lifestyle changes, diet and urbanisation-besides personal choices which has seen women delivering fewer children later in life than was previously the case when it was common for one woman to have 10 children before their 30th birthday.

Dr Frederick Kairithia, an Obstetrician/Gynaecologist, says though fertility ratios have dipped in the country, women have turned to technology to boost fertility, thus increasing the chances of delivering twins.

Dr Kairithia says most women are opting for fertility-inducing drugs and technology like In Vitro Fertilisation (IVF) to give birth to twins-whose number in Kenya is proportionate to the global ratio: about 1.6 million twins are born annually around the world, with one in every 42 newborns being a twin, he says.

Dr Ndegwa, concurs that use of IVF has seen more women delivering twins unlike in the past when most would depend on natural twinning.

Dr Ndegwa says there are two types of twins identical (monozygotic) and fraternal ((dizygotic). To form identical twins, one fertilised egg (ovum) splits and develops into two babies with exactly the same genetic information. With fraternal twins, two eggs (ova) are fertilised by two sperm and produce two genetically unique children.

Both phenomena have been occurring naturally even before IVF which has helped many women to get pregnant or have multiple pregnancies.

Dr Ndegwa, however, says there are certain factors that contribute to multiple pregnancies like being born in a family with twins especially on the paternal side, where the gene may be passed across generations.

Dr Ndegwa adds that women who have polycystic ovary syndrome (PCOS) have a higher likelihood of twinning while some countries in Africa like Nigeria, especially the Yoruba have a high rate of twins owing to their diet.

“It is believed that yams commonly found in Nigeria and other countries in West Africa have a high level of phytoestrogen, a component that may affect their fertility,” she explains.

Dr Ndegwa explains that identical twins are not a genetic phenomenon and just happens spontaneously when the cells divide faster, forming two different people.

She, however, notes that many women are requesting to get twins through IVF as most patients had waited for more than five years to get pregnant and with technology most opt for twins “to get a maximum number of children,” but this is not guaranteed.

In IVF, the sperm is put together with the egg and put back as two embryos but sometimes nothing will form, sometimes one does and sometimes both form, resulting in twins, according to Dr Ndegwa.

“For most of the transfers, actually 99 per cent of them, we put back two embryos, but it is not a must we get twins because of other factors, including whether the two embryos attached to the uterus,” she says.

The IVF begins when a woman is given injections to hyper-stimulate all the eggs they can give which are about 10-20 eggs with a sample from the husband or sperm donor.

The eggs and sperms are then put together in the incubator for about five days as they divide and then two of the embryos are put back into the womb.

Dr Ndegwa says that successful implantation cannot be determined and that is the main reason they put two embryos in the womb to increase the probability of implantation.

She adds that some women are given medication leading to ovulation of more than two eggs, hence the higher chances of twining- which is a wonderful feeling, but overwhelming feeling for a mother.

Women, should thus, think through it, she advises.

“For starters the pregnancy itself is stressful; you get double nausea, double the vomiting, but also taking care of multiple children can be draining, especially without a good support system,” explains Dr Ndegwa.

Additionally, a woman is more prone to gestational diabetes, and hypertension in pregnancy and at some point, one might need to go on bed rest which will affect their income.

“Multiple pregnancies tend to come out earlier than the expected 40 weeks, of pregnancy, or the nine months, especially triplets tend to come at seven months increasing the cost of hospitalisation,” warns the specialist.

Dr Ndegwa also argues that some women will require counselling before getting their children because it is a high-risk pregnancy and they need to be well prepared.   

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