Assisted reproductive interventions and multiple birth

Area of Science:

• Reproductive Medicine
• Obstetrics
• Public Health

Background:

• Multiple births carry higher risks for both mothers and infants.
• Assisted reproductive technologies (ART) and ovulation induction are increasingly used for fertility treatment.

Purpose of the Study:

• To determine the impact of ovulation-inducing drugs and ART on the incidence of multiple births.
• To investigate the association between assisted conception and multiple birth rates.

Main Methods:

• A historic prospective study of 13,151 women delivering between 1996-1999.
• Analysis of pregnancies resulting from ART or ovulation induction versus natural conception.
• Primary outcome measure was the rate of multiple births.

Main Results:

• A 25-fold increased likelihood of multiple birth was observed in women using assisted conception.
• Assisted conception treatments were attributable to 33% of all multiple births in the cohort.
• No independent association was found between advanced maternal age and multiple birth after adjusting for assisted conception.

Conclusions:

• Assisted reproductive interventions are strongly linked to increased multiple birth rates.
• While older women use ART more, advanced maternal age is not an independent risk factor for multiple births.
• The rise in ART-related multiple births raises significant public health concerns due to associated morbidities.