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Origin of multiple pregnancies in a subfertile population
Monique Brandes1, Carl J C M Hamilton, Kim A Y J Bergevoet
1Department of Obstetrics and Gynecology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands. m.brandes@jbz.nl
Acta Obstetricia Et Gynecologica Scandinavica
|September 1, 2010
Summary
In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatments significantly contribute to multiple pregnancies in subfertile populations. Focusing on twin prevention strategies like elective single embryo transfer (eSET) is crucial.
Area of Science:
- Reproductive Medicine and Endocrinology
- Obstetrics and Gynecology
- Human Reproduction Research
Background:
- Subfertility affects a significant portion of the population, necessitating various treatment modalities.
- Multiple pregnancies, while sometimes a desired outcome of fertility treatments, carry increased risks for both mother and child.
- Understanding the specific contribution of each subfertility treatment to multiple pregnancies is essential for optimizing treatment protocols.
Purpose of the Study:
- To quantify the contribution of distinct subfertility treatments to the incidence of multiple pregnancies.
- To identify which fertility treatments are most strongly associated with multiple gestations in a subfertile cohort.
Main Methods:
- Prospective cohort study conducted between January 2002 and December 2006.
- Data collected from 1,001 continuing pregnancies at a subfertility clinic in the Netherlands.
- Documented mode of conception, pregnancy outcome, and singleton vs. multiple status for all registered pregnancies.
Main Results:
- In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) were responsible for over half of the multiple pregnancies.
- Intra-uterine insemination with controlled hyperstimulation (IUI/(COH)) contributed to 18% of multiple pregnancies.
- Spontaneous conceptions accounted for approximately 11% of multiple pregnancies, while clomiphene citrate (CC) and follicle-stimulating hormone (FSH) had lower contributions.
Conclusions:
- IVF/ICSI are the primary drivers of multiple pregnancies within this subfertile population.
- Emphasis on twin prevention strategies, particularly elective single embryo transfer (eSET), is recommended.
- Consideration should be given to delaying IVF treatment when spontaneous conception is likely.
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