Such events are not uncommon following IVF. The incidence of a clinical twin pregnancy after IVF is 10% to 33%, with the exact likelihood depending on the number of embryos transferred and the age of the patient. In 30% to 40% of these pregnancies, one gestational sac will be empty, a situation called a blighted ovum pregnancy. Often, these pregnancies will simply disappear. At other times, the woman may experience cramping and bleeding. In such a case, there is a 40% to 50% risk that the healthy gestational sac and fetus will also abort. There is no way to predict the outcome, and there is no medical intervention that can be implemented to preserve the normal sac and fetus. During this difficult time, patients are well advised to rest and decrease their stress as much as possible. Supplemental progesterone may help quiet uterine contractions, but it is not curative.
In women who suffer a twin early pregnancy loss, a medical investigation may be indicated to search for any causes that may have contributed to the early pregnancy loss. Unfortunately, such evaluations may not produce any definitive answers (see Questions 92–99).
During my first pregnancy, I lost a twin at 8 weeks after fetal cardiac activity was visualized. I do recall a severe episode of cramping, but there was no bleeding involved. In addition to my RE, the other medical professionals involved confirmed that no intervention was necessary. I went on to enjoy a very normal pregnancy and delivered my son at 40.5 weeks.