Louis Brown, the world’s first IVF baby, now has a child of his own, and millions of IVF babies have been born around the world, fulfilling the dreams of many infertile couples to become parents. As IVF has evolved, more and more people have become concerned about the safety of this technology. Unlike a normal pregnancy, the mother’s eggs mature at supraphysiological levels of hormones, and the eggs and sperm are fertilized and grow and develop in a culture medium in a Petri dish. Do these supraphysiological levels of hormones and in vitro manipulations have an impact on the developmental potential of the embryo? There are many studies that show no significant differences between IVF and naturally conceived babies, and that they are similar in terms of physical health as well as intellectual and emotional well-being. And, of course, follow-up and research should always be done; after all, the first IVF baby is now only 38 years old. But the rate of multiple pregnancies in IVF is much higher than in natural pregnancies, mainly because women undergoing IVF treatment are allowed to transfer two embryos and, in patients >35 years old, three embryos. Twin pregnancies are actually very risky. The rate of spontaneous abortion in twin pregnancies is 2 to 3 times higher than in singleton pregnancies. The greater the number of fetuses, the greater the risk of miscarriage, which is associated with embryonic malformations, abnormal placental development, impaired placental circulation and relative narrowing of the uterine cavity volume. The incidence of hypertensive disorders in twin pregnancies is three times higher than that in singleton pregnancies, with early onset of symptoms and more severe cases, often not easily controlled, and an increased incidence of eclampsia. The incidence of amniotic fluid excess in twin pregnancies is 12% and is associated with twin fetal transfusion syndrome and fetal malformations. Placenta abruptio is the main cause of prenatal hemorrhage in twin pregnancies, which has a rapid onset and development and poses a serious threat to maternal and child health. Due to the large area of the placenta, it is easy to extend to the lower part of the uterus and cover the endocervix, forming placenta praevia, the incidence of which is 1 times higher than that of a singleton. The incidence of intrahepatic cholestasis during pregnancy is twice as common in twin pregnancies as in single pregnancies, and the disease is likely to cause preterm labor, fetal distress, stillbirth, and stillbirth. In multiple pregnancies, the uterine fibers are overstretched resulting in weak uterine contraction and large disc attachment surface, which predisposes to postpartum hemorrhage and increases the chance of infection. When the number of fetuses is large and the complication is excessive amniotic fluid, the intrauterine pressure is too high and the incidence of preterm labor is high. Most preterm births occur spontaneously or after premature rupture of membranes. Intrauterine pressure may lead to fetal malformations such as deformed feet and congenital hip dislocation. In addition, ovulation promotion may lead to ovarian hyperstimulation syndrome. After ovulation promotion, many follicles develop at the same time, estrogen in the body rises sharply, vascular permeability increases, and body fluid inside the blood vessels is lost to the lumen, forming ascites and pleural fluid, resulting in abdominal distension, chest tightness and breathlessness, oliguria, and blood concentration inside the blood vessels, making it easy for thromboembolism to occur. In severe cases, it can be life-threatening. If severe ovarian hyperstimulation syndrome occurs, we will advise the patient to cancel the fresh cycle transplant and hospitalize the related symptoms to prevent further deterioration of the condition. There is still a risk involved in trying to get a child. If a patient chooses to undergo a single blastocyst transfer, we are happy because it reduces multiple pregnancies and complications during pregnancy; when we encounter patients with polycystic ovary syndrome or very good ovarian reserve, we also have the headache of what to do if we promote all of them with so many small follicles. As fertility doctors, we think like the patient couple, not to blindly pursue pregnancy rate, but to give the patient a healthy baby and a healthy pregnancy.