Lets be real for many hopeful LGBTQ+ parents pursuing IVF and surrogacy, the idea of having twins can sound like a dream. Two kids, only one intense journey, and then your family-building is complete. Who wouldnt love that?When my husband and I were building our family more than 15 years ago, we went the twin route, too. But in the years since we became parents, medical advice has shifted. Dramatically. Most fertility doctors are now advising against transferring two embryos. And its not because they dont want to help us build our families; its because their number one goal, like ours, is a healthy pregnancy and a healthy baby. And thats most safely achieved with one embryo, not two. Related Family-building while queer isnt easy. You dont have to do it alone. Heres what weve learned from some of the incredible doctors in the GWK Academy network like Dr. Allison Bloom of Main Line Fertility and our biological family-building medical advisor, Dr. Mark Leondires of Illume Fertility and why many of them are encouraging queer parents to think twice about trying for twins.Twins come with real risks Never Miss a Beat Subscribe to our newsletter to stay ahead of the latest LGBTQ+ political news and insights. Subscribe to our Newsletter today As Dr. Bloom explains, Many intended parents ask about having twins. While people often think this is an ideal way to complete their family, it does come with increased risks and potentially increased costs.Dr. Mark Leondires of Illume Fertility | Provided by GWK Academy The biggest concern? Preterm birth. Twin pregnancies are much more likely to result in babies being born early and preemies often face lifelong complications. These can include breathing issues, developmental delays, and even long-term hospital stays in the NICU.And the risks arent just for the babies they apply to your gestational carrier, too. Carrying twins increases the chances of serious pregnancy complications like preeclampsia (dangerously high blood pressure), gestational diabetes, and the need for a C-section (even if theyve delivered vaginally in the past). Theyll need more prenatal visits, more monitoring, and may need to stop working earlier than planned.Thats not only hard on the surrogate it can also lead to you incurring higher medical, insurance and agency-related costs than youd expected.The American Society for Reproductive Medicine (ASRM) is the leading U.S. medical organization that develops clinical and ethical practice standards for reproductive medicine, including IVF and surrogacy. They issue Practice Committee and Ethics Committee guidelines that serve as the backbone for clinic protocols and provider behavior nationwide. Simply put, ASRM recommends a single embryo transfer as the standard to minimize the risks of multiple gestation for both carriers and babies when embryos originate from an egg source less than age 35 or if they have been tested to be chromosomally normal. The money-saving myth Heres a misconception we hear a lot: Twins will save me money because Ill only need one surrogate and shell carry both embryos in one journey.That might be true but only if everything goes perfectly. And we all know how rare perfect is on these journeys.If complications arise, or your babies need extended NICU care, or your gestational carrier requires extra support either before or after birth all these expenses can quickly eclipse the total costs involved for two separate singleton journeys. The mental health toll Plus, not all twin embryo transfers actually result in twins. Sometimes, one embryo simply doesnt implant. If youre using two sperm sources (which many of our families do), you might not know who the biological father is until the baby is born. That can carry its own emotional toll especially if one dads embryo didnt make it.Theres also the possibility of vanishing twin syndrome, when one embryo begins developing but miscarries early on. That can be heartbreaking, especially if both parents were expecting to have a biological connection to a child.Licensed Marriage & Family Therapist Joey Guzman-Kuffel expresses, Twins bring double the joy, but also double challenges, especially when it comes to balancing identity, partnership, and parenting roles. When having twins, there is an increased risk for experiencing anxiety, stress, or even feelings of being overwhelmed by the responsibility of caring for two babies at once. There is also the heightened risk for experiencing sleep deprivation which can trigger postpartum mood disorders in non-gestational parents, like gay dads.Licensed Marriage & Family Therapist Joey Guzman-Kuffel | Provided by GWK Academy The surrogacy gap Fewer gestational carriers are open to carrying twins. Many agencies (including the ones we vet through GWK Academy) have specific requirements a carrier might need to have already carried twins to term, or she might need special medical clearance.That means it could take significantly longer to match with a surrogate willing to carry twins, slowing down your journey, often by many months. So whats the safest option?Single embryo transfer. Thats the answer youll hear again and again from the doctors we trust.Dr. Leondires says it clearly: As a fertility doctor, my goal is a healthy pregnancy and a healthy baby. A single embryo transfer and a singleton pregnancy is the safest way to achieve that goal. We always need to consider what leads to the healthiest childhood outcomes, and it is clear that is a singleton gestation.Dr. Mark Leondires | Provided by GWK Academy And while some clinics will transfer two embryos under certain circumstances (and after thorough counseling), most fertility clinics are making elective single embryo transfer their standard recommendation especially for gestational carrier journeys.What if you really want two kids close in age?Heres a creative and safer option that some GWK Academy families pursue: Two surrogates, each carrying one embryo, with the second surrogate starting her journey once the first surrogate has cleared her first trimester. Why separate the two journeys by three months? Because this way it will be much less likely that youll have two surrogates giving birth around the same time, which could be problematic, presuming your surrogates may not live anywhere near each other.Yes, this does prove to be more expensive up front, but it can help you have two children close in age without the medical risks of a twin pregnancy. Plus, take it from someone whose first baby was a singleton and whose second babies were twins: It is MUCH easier to care for one newborn baby those first three months than it is to care for two!At the end of the day, I know how tempting the twin dream can be. But as someone whos walked this path and now helps guide countless LGBTQ+ people through it I urge you to listen to your medical team, get informed, and think long-term.While the dream of twins can be tempting, the most important goal is a safe and healthy journey that results in you holding your baby in your arms.At GWK Academy, we help LGBTQ+ intended parents navigate the surrogacy process safely and confidently, connecting you with ethical, LGBTQ+-affirming clinics and agencies that follow best medical practices.You deserve a healthy baby and a smooth journey. And in almost every case, that means taking it one embryo at a time.Want to learn more about surrogacy & IVF? Join GWK Academy for free now for personalized coaching and access to a network of trusted, LGBTQ+ affirming fertility clinics and experts. Were here to guide you every step of the way.Subscribe to theLGBTQ Nation newsletterand be the first to know about the latest headlines shaping LGBTQ+ communities worldwide.