We are honored to work with compassionate and dedicated surrogates who are willing to help intended parents achieve their family goals—whether that means carrying one baby or two. Every year, about 10% of our intended parents and surrogates mutually agree to a double-embryo transfer, ensuring that all decisions are made with care, medical guidance, and open communication.

While GSHC Surrogacy is not against DET, we believe it should only be pursued when all parties fully understand the possible outcomes, medical risks, and financial considerations. We are here to guide intended parents and surrogates through this decision with transparency, warmth, and unwavering support.

1. Making the Decision Together: Agreement Between Intended Parents & Surrogates

A two-embryo transfer is a shared decision that requires thoughtful discussion and mutual understanding between intended parents and the surrogate. These conversations happen before matching and are outlined in the surrogacy contract to ensure clarity and alignment.

Key Considerations in the Agreement:

✔ Surrogate’s Willingness & Comfort Level – Some surrogates prefer carrying a singleton, while others are open to carrying twins to support their intended parents’ wishes. We deeply appreciate surrogates who take this step with kindness and generosity.

✔ Medical Evaluation by the Fertility Clinic – The surrogate’s health history, previous pregnancies, and uterine condition must be evaluated to ensure a twin pregnancy is safe.

✔ Intended Parents’ Goals & Expectations – Some intended parents choose DET to increase the chances of pregnancy, while others hope for twins as part of their family-building journey.

✔ Selective Reduction Policies – If both embryos implant, IPs and the surrogate must discuss whether selective reduction would be considered in case of medical necessity.

✔ Possibility of a Triple Pregnancy – In rare cases, one of the transferred embryos may split into two, resulting in a triplet pregnancy. In these situations, selective reduction is often necessary for the safety of the surrogate and babies.

✔ Financial Preparedness for NICU Care (If Needed) – Twin and triplet pregnancies have a higher chance of requiring NICU care, which can lead to unexpected medical expenses.

💡 At GSHC Surrogacy, we help facilitate these discussions with warmth and understanding, ensuring that both intended parents and surrogates feel heard and supported.

2. What Can Happen? Possible Outcomes of a Two-Embryo Transfer

A two-embryo transfer does not always result in twins. There are four possible outcomes:

A. Singleton Pregnancy (One Embryo Implants, One Does Not)

✔ Most common outcome – One embryo implants, while the other does not develop.

✔ The result is a singleton pregnancy, even though two embryos were transferred.

B. Twin Pregnancy (Both Embryos Implant Successfully)

✔ Both embryos implant, leading to a twin pregnancy.

✔ This requires closer medical monitoring due to higher risks (see below).

C. Triplet Pregnancy (One Embryo Splits Into Two, One Remains Singleton)

✔ Rare, but possible – One of the transferred embryos splits into identical twins, while the second embryo implants as a singleton.

✔ Higher risk of complications – Triplet pregnancies carry significant risks for both the surrogate and babies.

✔ Selective reduction is often needed – To protect the surrogate’s health and increase the chances of healthy birth outcomes, most triplet pregnancies require reduction to twins or a singleton.

D. No Pregnancy (Neither Embryo Implants)

✔ In some cases, neither embryo implants, and the transfer is unsuccessful.

✔ If this happens, the fertility doctor will assess why the transfer didn’t work and discuss next steps.

💡 No matter the outcome, GSHC Surrogacy supports both intended parents and surrogates through every stage of the journey.

3. The Realities of Carrying Twins or Triplets: What Surrogates and IPs Should Know

While many twin pregnancies are healthy, they require additional medical monitoring and care due to increased risks for both the surrogate and babies.

Risks for the Surrogate Mother:

✔ Higher chance of requiring a C-section – Twin and triplet pregnancies are more likely to require surgical delivery(ACOG, 2021).

✔ Increased risk of gestational diabetes & pre-eclampsia – Multiple pregnancies place greater physical strain on the surrogate (Goldenberg et al., 2008).

✔ More discomfort – Carrying twins or triplets may lead to greater fatigue, nausea, and back pain.

✔ Higher risk of preterm labor and early delivery – More than 60% of twin pregnancies and nearly 100% of triplet pregnancies deliver before 37 weeks (Hack et al., 2005).

4. Financial Considerations: The Cost of NICU Care for Multiples

Twin and triplet pregnancies significantly increase the likelihood of preterm birth, which may require Neonatal Intensive Care Unit (NICU) treatment. Intended parents should be financially prepared for these potential expenses.

Estimated NICU Costs:

✔ Average NICU stay for preterm twins or triplets: 2 to 8 weeks

✔ Cost per day in the NICU: $3,000 - $5,000+ per baby (March of Dimes, 2022)

✔ Total estimated NICU cost for multiples: $75,000 - $300,000+, depending on the length of stay and level of care

💡 GSHC Surrogacy encourages intended parents to review their insurance coverage and financial plans to ensure they are prepared for any NICU-related expenses.

5. A Decision Made with Love and Care

✔ Approximately 10% of intended parents and surrogates at GSHC choose a two-embryo transfer each year.

✔ While rare, some two-embryo transfers result in triplet pregnancies due to embryo splitting.

✔ Selective reduction is often necessary in triplet pregnancies to protect the surrogate and increase the chances of a healthy birth.

✔ Twin and triplet pregnancies require additional monitoring, and intended parents should be prepared for potential NICU costs.

✔ At GSHC Surrogacy, we walk this journey with you, ensuring that every decision is made with clarity, warmth, and compassion.

💙 Every surrogacy journey is unique, and GSHC Surrogacy is committed to supporting intended parents and surrogates with care, respect, and dedication.

Start Your Surrogacy Journey Today!

📩 Contact us now to learn more about becoming a surrogate mother and making a life-changing difference for intended parents!
📞 Call: 310-953-0137
📍 Apply to Become a Surrogate: Start Your Application Here

Follow Us for Surrogacy Insights & Updates!

📲 Stay connected and learn more about surrogacy through our social channels:

• YouTube: @GSHCsurrogacy
• Instagram: @gshc_surrogacyagency
• TikTok: @gshc_gcsurrogacyagency
• Facebook: GSHC Surrogacy Agency
• LinkedIn: GSHC Surrogacy