A conservative treatment protocol with human menopausal gonadotropins aimed at reducing multiple births

Area of Science:

• Reproductive Endocrinology
• Obstetrics and Gynecology
• Human Reproduction

Background:

• Human menopausal gonadotropins (hMG) therapy is widely used for ovulation induction.
• Previous studies indicate a significant risk of multiple gestations with hMG therapy.
• A conservative stimulation regimen aims to optimize pregnancy rates while potentially mitigating risks.

Purpose of the Study:

• To evaluate the multiple birth rate, particularly for triplets or higher, in pregnancies resulting from a conservative hMG stimulation protocol.
• To determine if a conservative hMG approach decreases the incidence of multiple gestations compared to general averages.

Main Methods:

• Analysis of 241 consecutive pregnancies achieved solely with hMG therapy.
• Detailed recording of gestation outcomes, including singletons, twins, and triplets or higher.
• Comparison of observed multiple birth rates with established literature data.

Main Results:

• A total of 15% (38/241) of pregnancies resulted in multiple gestations.
• Of the multiple gestations, 15% (6/38) were triplets or higher.
• The observed multiple birth rate and higher-order multiple birth rate were not statistically different from average rates, despite a conservative regimen.

Conclusions:

• A conservative hMG stimulation protocol resulted in a 15% multiple birth rate, with 15% of these being triplets or higher.
• Even with a conservative approach, multiple gestations remain a significant risk in hMG therapy.
• Further strategies may be needed to reduce the incidence of multiple births in assisted reproductive technologies.