Babies, the easy way?

But the greatest danger comes from implanting more than one embryo at a time, something often done to try to guarantee a successful outcome and eliminate the need to perform the procedures repeatedly. (Such procedures are costly, and failed attempts can be frustrating for couples going through the process.) "Across the board, the biggest risk of ART stems from the increased likelihood of multiple births," Cedars says. According to the Centers for Disease Control and Prevention, about 45% of pregnancies conceived with assisted reproductive technology result in twins and roughly 7% in triplets or more.

Carrying more than one baby dramatically increases the chances of pregnancy-related complications. More than half of twins and more than 90% of triplets are born prematurely, and women expecting multiple births are at extra high risk of developing conditions such as high blood pressure and diabetes.

To reduce the likelihood of multiple pregnancies, the Society of Assisted Reproductive Technology and the American Society for Reproductive Medicine have established guidelines for the number of fertilized embryos to be transferred to the uterus during a cycle of infertility treatment. For women younger than 35, they recommend transferring no more than two embryos at a time and suggest that one embryo may be sufficient for those women who are most likely to become pregnant.

Researchers are also studying new ways to identify the best embryos to transfer. "If we can determine which embryos are most likely to take, we can decrease the number that are transferred and reduce the risk of a multiple pregnancy," Cedars says.

Sometimes the hardest thing to do, however, is to convince patients that they don't want a multiple pregnancy. Men and women trying desperately to conceive often love the idea of having twins or even triplets. They get the family they want without the trouble (and expense) of going through infertility treatments all over again.

"While the goal is to help patients with family building, patients want a healthy baby," Cedars says. "We want to make sure we're not adding to the risk with ART." Additional research will help determine exactly how safe or risky these procedures are, identifying ways to improve them.

For couples struggling with infertility, these technologies may be the only option. They are not intended for those who simply grow impatient with trying to get pregnant the old-fashioned way.