Fetal Reduction
Book an AppointmentWhat is fetal or embryo reduction?
Fetal Reduction is a procedure used to reduce the number of fetuses in a multiple pregnancy, usually to two to decrease the health risks to the mother & decrease the risk of complications to the remaining fetuses. The goal of fetal reduction is to increase the chance of a successful, healthy pregnancy.
What are the risks associated with multiple pregnancy?
If a pregnancy involves 3 or more fetuses, the risks of miscarriage, stillbirth premature rupture of membrane, early delivery, structural malformation & early neonatal death increase with each additional fetus.
Premature delivery affects babies’ lungs, heart, stomach, and brain . It can cause long term health issues in babies like cerebral palsy, intellectual disability, and vision & hearing loss, obesity chronic hypertension & diabetes
Maternal risk like anaemia, gestational hypertension, preeclampsia, gestational diabetes, antepartum & postpartum hemorrhage also increases with multiple pregnancies. It further causes economic & mental challenges to family. Parents of multiples pregnancies are at an increased risk of severe stress and depression
What are the benefits of embryo reduction?
Multifetal pregnancy reduction may maximize the woman’s health and the health of her surviving neonates. It substantially increases the duration of pregnancy, reduces the incidence of premature delivery which in turn has the benefit of increasing the baby’s birth weight and reducing neonatal morbidity & mortality along with shortening the neonatal intensive care stay. The benefits are even more pronounced with quadruplets and other higher order multiple pregnancies.
Is mutifetal reduction & Selective Reduction same?
In Selective reduction, one of the fetuses who have a grave and incurable disease is electively reduced, to allow pregnancy to continue for the sake of the healthy fetus or fetuses. However, in multifetal pregnancy reduction, fetus is reduced in cases of high-order multiple pregnancies (more than three fetuses) to reduce the obstetrical and perinatal risks inherent in this kind of pregnancy.
Role of fetal reduction in an IVF conceived pregnancy?
IVF is associated with increased incidence of multiple pregnancies. However, it may seem paradoxical in an IVF pregnancy as so much effort is involved to get pregnant; embryo reduction is advised with aim to not just conceive, but to give the mother a healthy baby at the end of pregnancy.
Is there any role of fetal reduction in twin pregnancy?
Certain medical (heart disease) or obstetric considerations (eg- uterine anomaly, history of cervical insufficiency, or preeclampsia) can significantly increase the risks of carrying even a twin pregnancy compared with a singleton pregnancy. A fetal reduction to a singleton may be an appropriate for these conditions and also for nonmedical reasons, such as financial, social, or emotional concerns.
When is the procedure of embryo reduction typically done?
If a couple or individual has decided for fetal reduction, a thorough ultrasound is usually done between 11-13 weeks. We at our center, prefer to do it at around 12 weeks when we can do the first trimester screening and also rule out any structural abnormality in the babies. The results of such tests may assist patients in making their decisions about intervention.
In addition, about 8 to 20% multiple pregnancies may reduce by themselves by the end of first trimester. The ‘vanishing’ twin does not have any adverse effect on the surviving fetus.
How is the procedure performed?
The fetus which displays signs of any abnormality is usually selected for reduction. In case all the fetuses appear normal during the scan, then the fetus that is easily approachable is targeted for reduction. It must be noted that fetuses are not selected based on gender. This is strictly prohibited under PCPNDT law and the sex of the fetuses is not revealed and is also not studied.
The most common method of fetal reduction is Trans abdominal (through the abdomen). For this procedure, the doctor uses ultrasound as a guide and inserts a needle through the mother’s abdomen and into the uterus to the selected & then injects the fetus with a potassium chloride/ lignocaine solution, which stops the fetal heart. Because the fetus is very small during the first trimester, the reduced fetus is usually absorbed by the mother’s body. This may include some vaginal bleeding.
Sometimes, we use a different technique called radiofrequency ablation instead in case of monochorionic pregnancy. A small needle device uses electric currents to cut off the blood flow from your umbilical cord to one or more fetuses.
What are the risks associated with the procedure?
After fetal reduction, there is a 5- 7 % chance that the woman will lose the entire pregnancy prior to 20 weeks’ gestation. The original number of fetuses, the route of the needle as well as the number terminated may influence the likelihood and the rate of pregnancy loss.
In small number of cases, women have a chance of going into labor too early. Other side effects include fever, vaginal bleeding, leaking or contractions. Infections from fetal reduction are rare.
The procedure usually does not have any adverse effect on the surviving fetus. In cases where a multi-fetal pregnancy of three or more fetuses is reduced to two fetuses, the remaining fetuses develop as they would if they had been conceived as twins. The benefits of fetal reduction far outweigh the risks associated with the procedure.
What should I expect after the procedure?
You will be asked to rest and the baby’s heart beat will be checked after half an hour of the procedure. You may have slight bruising at the site of needle entry. You may also have some spotting or mild cramping for a couple of hours for which you may take oral paracetamol. There is no restriction to your daily activities though the doctor may advice you to stay home for 3 days to minimize chances of infection.
If you have fever, vaginal bleeding or leaking or contractions, you must report to the hospital.
Counseling is recommended after the procedure because fetal reduction is a traumatic event. The patient and her family may feel guilty about undergoing the procedure.
For Appointment Contact:
Maternal fetal medicine unit
Seeds of Innocence (South Delhi)
Fertility & fetal care Centre New Delhi 3, MMTC/STC Colony, Geetanjali Enclave, New Delhi-110017.
Seeds of Innocence (Ghaziabad)
Fertility & fetal care Centre: opp. Nehru Stadium Jogging Track, Ram Nagar, Pocket L, Nehru Nagar III, Nehru Nagar, Ghaziabad, U.P. 201001.
Ph no.: +91 9810350512
Email-info@seedsofinnocence.com
Seeds of Innocence Expertise
At seeds of innocence, our team of experts is equipped with all the latest technology to ensure better & faster results for patients. We provide in-house consultation to expecting mothers and ensure the best experience for expecting mothers.
FAQ’s
Q. What is an antenatal test?
Antenatal tests include different types of urine & blood tests to evaluate the well-being of both the fetus & expecting mother.
Q. How do you do an antenatal check-up?
The antenatal check-up includes evaluations of patient history, physical examination, & laboratory investigation.
Q. What happens in your first antenatal appointment?
In the first antenatal visit to a specialist, an expecting mother is likely to get a health assessment, report of pregnancy confirmation, and a detailed plan for the coming months.
Q. How vital is antenatal care?
An antenatal check-up allows early detection & prevention of complications that can be harmful to expecting mother & the fetus.
Q. When should antenatal care start?
Antenatal care should start between 8-12 weeks of pregnancy confirmation. This allows a specialist to provide the best consultation.
Our Doctors

Dr. Gauri Agarwal
Infertility Specialist
Dr. Gauri Agarwal is a young, dynamic and leading fertility specialist of Delhi/NCR. Dr. Agarwal is backed by a visionary thinking, die-hard determination and industry-rich experience of more than 10 years. She is the Director, IVF at Seeds of Innocence Centre. Dr. Agarwal finished her MBBS degree from Bharati Vidyapeeth Medical College, Pune. Post that, she did a Diplomate of National Board (DNB), Obstetrics and Gynaecology Residency Program from KG Superspecialty Hospital, Coimbatore. She followed this with a hard-earned Fellowship Program in Reproductive Medicine (Infertility) from the University of Gent, Belgium. Further, she received training in Embryology at the National University of Singapore.

Dr. Julie Chhawchharia
Infertility Specialist
Dr. Julie Chhawchharia, is a competent and committed Infertility specialist in Reproductive Medicine with around a decade of extensive experience along with experience in obstetrics and gynaecology. She has been performing vaginal deliveries, caesarean sections, and various gynaecological surgeries.. She is an acknowledged expert in Reproductive Medicine services by DY Patil University, Navi Mumbai. She is also a meritorious and Gold award-winning student of Fellowship and Diploma in Minimal Access Surgery (Laparoscopy) from the prestigious World Laparoscopy Hospital, Gurgaon in 2014. She completed her MBBS degree and MS in Obstetrics and Gynaecology from the renowned Institute JJM Medical College in Davangere, Karnataka.

Dr. Seema Madan
Infertility Specialist
Dr. Seema has done her M.D (Obstetrics & gynecology) from Maharshi Dayanand University, Rohtak Haryana. She has 19 year experience in Gynecology. Before joining Seeds of Innocence she was at ART at KJIVF and Laparoscopy Center as Consultant. She also worked at Fortis Bloom IVF, lady Harding Medical College, and Fortis Escorts Hospital & Research Centre.

Dr. Kriti Tiwari
Clinical Centre head
Dr. Kriti Tiwari is a qualified medical professional working as Clinical Centre head at Seeds Of Innocence, Malviya Nagar with more than 5 years of experience in infertility workup and management. She has completed her MBBS, M.S. Obstt. & Gynaecology, senior residency and FNB reproductive medicine all from one of the prestigious medical college of India, Maulana Azad Medical college, Delhi. Her key functioning areas in the field of infertility includes counselling and handling OPDs of patients with strong diagnostic skills, IUI, IVF, ICSI Procedures, IVF-embryo transfer, andrology, surgical sperm retrieval by PESA, TESA, laparoscopy & hysteroscopy and obstetric management of patients. Dr. Kriti Tiwari is conscious for improving the quality of life of patients through accurate diagnosis, timely intervention and ethical treatment by expertise in managing difficult cases like multiple IVF failures, severe endometriosis, poor responders and severe male factor with high success rates. She has always been updated in the education of her relevant field by training many junior doctors under her, attending several conferences in her field. She has published various papers and chapters in renowned books and made contribution in this field. Her recent publication was a chapter on “conservative management of ectopic pregnancy” in Manual of ART and laboratory Sciences, 2022.

Dr Hina Ali
Infertility Specialist
Dr. Hina Ali, is a highly qualified and accomplished medical professional with a specialization in Reproductive Medicine. Dr. Ali holds an MBBS degree from the prestigious Maulana Azad Medical College in Delhi, India, and completed her MS from UCMS & GTBH, Delhi. With a remarkable track record, she was awarded the Gold Medal for her FRM fellowship. Dr. Ali has over ten years of experience in the medical field, and her expertise in IVF spans over seven years. With her vast knowledge and skillset, Dr. Hina Ali is dedicated to providing the highest quality care to her patients.

Dr. Mangla
Obstetrics and Gynaecology
Dr. Mangla is a highly qualified professional, with an M.B.B.S. degree from Gandhi Medical College, Bhopal, Madhya Pradesh in 1989, and an M.D. in Obstetrics and Gynaecology from the same institution in 1993. She has also completed fellowships in fetal Sonography & Infertility from prestigious organizations. With a pioneering spirit, she established the first IVF center in Bhopal and has since gained more than 25+ years of vast experience. Dr Mangla is an astute professional with rich and extensive experience in Interventional Sonography. Her expertise extends to all facets of clinical practice, including patient care, research, and academics. She has also been a key member of the organizing committee for numerous national and international conferences focused on ART procedures.

Dr. Nivedita
Infertility Specialist
Dr. Nivedita is a highly qualified medical professional, holding an M.B.B.S. degree from Era Medical College in Lucknow, Uttar Pradesh, India. She completed her Compulsory Rotating Internship training from 2013 to 2014, further demonstrating her commitment to excellence in the medical field. She has also earned an M.S. in Obstetrics and Gynaecology from D.Y. Patil Medical College in Kolhapur, Maharashtra, India, showcasing her dedication to specialization in this area of medicine. In addition to her formal education, Dr. Nivedita has undergone rigorous training and achieved fellowships in fetal Sonography, Infertility, and Hysteroscopy from renowned organizations. Her extensive education and training have equipped Dr. Nivedita with the knowledge, skills, and expertise to provide her patients with exceptional medical care. Her commitment to professional development and her dedication to staying current with the latest medical advancements make her a highly respected and trusted medical practitioner in her field.