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Related Experiment Videos

The causes of high-order multiple gestation.

M S Rein1, R L Barbieri, M F Greene

  • 1Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts.

International Journal of Fertility
|May 1, 1990
PubMed
Summary

Human menopausal gonadotropin (hMG) is no longer the primary cause of high-order multiple gestations. Advances in monitoring ovulation induction therapies, like clomiphene, have reduced hMG

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Area of Science:

  • Reproductive Endocrinology
  • Maternal-Fetal Medicine
  • Obstetrics

Background:

  • High-order multiple gestations, such as triplets and quadruplets, were historically linked to human menopausal gonadotropin (hMG) therapy.
  • The introduction of serial ovarian ultrasound evaluation in the mid-1970s aimed to mitigate hMG-induced high-order pregnancies.

Purpose of the Study:

  • To evaluate the impact of evolving reproductive technologies on the causes of high-order multiple gestations.
  • To assess the current landscape of conception methods leading to triplet and quadruplet pregnancies.

Main Methods:

  • Retrospective review of deliveries at an institution between 1983 and 1987.
  • Analysis of conception methods (spontaneous, ovulation induction, IVF) for high-order multiple pregnancies.

Main Results:

  • Out of 35,119 deliveries, 13 triplet and 2 quadruplet pregnancies occurred.
  • Ovulation induction was associated with 73% of high-order gestations.
  • Clomiphene citrate accounted for 82% of ovulation induction cases, with hMG used in only 18%.

Conclusions:

  • hMG therapy is no longer the predominant cause of triplet and quadruplet pregnancies at this institution.
  • Serial monitoring of ovulation induction cycles, including serum estradiol and ovarian ultrasound, may have contributed to the observed decrease in hMG-related high-order gestations.

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