How is Multifetal Pregnancy Reduction Performed?

Posted On: September 9, 2020 By Simi Gupta, MD

There are certain risks that come with carrying a pregnancy that has more than one fetus, and one effective way to reduce your risks is by undergoing a multifetal pregnancy reduction procedure. Although it can be difficult to decide to undergo one and navigate the process, it’s important to understand your options and what it will mean for you and your health. Your maternal fetal medicine specialist can guide you through the process, but here’s what to know about this option and how it can help. 

What is multifetal pregnancy reduction? 

Multifetal pregnancy reduction (MPR) is a procedure that has the goal of reducing the total number of fetuses when you have more than one fetusThis can increase your chances of having a healthy pregnancy and help the remaining fetus or fetuses survive if you’re at a high risk for complications. It’s most often done at between 11 and 14 weeks of pregnancy, usually after genetic testing is performed to determine if any concerns are present. MPR can be difficult to deal with for you and your partner, so it’s important to partner with a maternal fetal medicine specialist who can help you manage what’s often an extremely emotional and complex situation. 

What can I expect during the procedure? 

MPR is performed using ultrasound as a guide. During the procedure, a needle is used to inject a drug into the fetus. This affects only specific fetuses and leaves the rest unharmed. Your body will absorb the affected fetuses over time. This can cause bleeding afterward but is perfectly normal.  

What are the risks? 

There are some risks involved with MPR, but they’re rare and your maternal fetal medicine specialist can ensure you know what to expect. MPR can cause miscarriage of the remaining fetus or fetuses, but it usually occurs in less than ten out of one hundred procedures. The rate of miscarriage can be higher based on the number of fetuses involved— the rate is highest when reducing from six or more fetuses. Conversely, the risk is lowest if you have fewer fetuses total before reduction. There’s also a very rare chance of infection. In many cases, MPR can be very emotionally challenging even when it’s considered medically necessary and you successfully carry the remaining fetuses. 

How can I lower my risks? 

It’s important to know that MPR does not reduce your risk of all pregnancy complications, so you should partner with a maternal fetal medicine specialist who can guide you through the process of ensuring a successful pregnancy. You may still give birth to children that have long-term health problems or conditions, so the right testing and care steps can help you prepare for getting your children the help they need after birth. Since MPR is more common for women who opt for in vitro fertilization (IVF), your reproductive endocrinologist and maternal fetal medicine specialist can recommend the best course of treatment for ensuring you don’t wind up with multiple gestations.  

Coping with multifetal pregnancy reduction 

It can be extremely distressing to consider MPR, and it’s perfectly normal to have feelings of sadness and grief throughout the process. Although your maternal fetal medicine specialist can help, it’s often recommended to seek out counseling services for you and your partner as you navigate your journey. Deciding to undergo MPR can be a difficult choice, so it’s important to find support as you go forward. 

Schedule an Appointment 

Your best first step for learning more about multifetal pregnancy reduction is by speaking with your maternal fetal medicine specialist who can discuss your options and the best course of treatment for you. To schedule an appointment with our award-winning team, we invite you to contact our New York City office by calling or filling out our online form. 


Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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