Author Interviews, NEJM, OBGYNE / 06.12.2013
Multiple Births and Fertility Treatments
MedicalResearch.com Interview with:
Aniket D. Kulkarni, M.B., B.S., M.P.H
Women's Health and Fertility Branch
Centers for Disease Control and Prevention
Atlanta, Georgia
MedicalResearch.com: What are the main findings of the study?
Dr. Kulkarni: Our study estimates the contribution of fertility treatments and natural conception to multiple births. Fertility treatments include IVF and non-IVF treatments. Non-IVF treatments primarily include ovulation induction and ovarian stimulation coupled with timed intercourse or intrauterine insemination (IUI). All estimated proportions were adjusted for maternal age which makes this study unique.
The incidence of twin births nearly doubled and the incidence of triplet and higher-order births quadrupled over the last 4 decades.
Our study estimates that by 2011, a total of 36% of twin births and 77% of triplet and higher-order births resulted from conception assisted by fertility treatments, after adjusting for maternal age.
After initial increase, the incidence of triplet and higher order births decreased by 29% from 1998 to 2011. The decrease in triplet and higher order births has coincided with a 70% reduction in the transfer of 3 or more embryos during IVF and a 33% decrease in the proportion of triplet and higher order births attributable to IVF. The decline in the number of embryos transferred during IVF became possible due to monitoring of ART treatments and outcomes and the work of professional societies, which have repeatedly revised practice guidelines to include recommendations for lowering the number of embryos transferred.
In contrast, non-IVF fertility treatments of ovulation induction and ovarian stimulation are estimated to contribute the increasing number of multiple births. Hence there is a need for surveillance of births from non-IVF fertility treatments.
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