Human Reproduction, Vol. 17, No. 5, 1411-1412,
May 2002
© 2002 European Society of Human Reproduction and Embryology
Prevention of high order multiple pregnancy
2 Service of Reproductive Medicine, Institut Universitari Dexeus, Pso. Bonanova 67, 08017 Barcelona, Spain E-mail: rostur{at}iudexeus.uab.es
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Dear Sir,
We thank Drs Dickey and Pyrzak for their interest in our paper. As clearly indicated in our study (Tur et al., 2001
), we used receiver operating characteristic curves to determine the cut-off point which best discriminated between high-order multiple pregnancy and low-order gestation for age, total number of growing follicles and estradiol concentration. According to our results, those cut-off points were 
32 years, more than three follicles and >862 pg/ml respectively. A strength of our study is that, in addition, these cut-off points were used to stratify the three predictive variables for the probability of high-order pregnancy. Thus, a prognostic table (Table II in our study) was constructed that may assist in providing better individualized counselling regarding HCG injection or withholding.
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Tur, R., Barri, P.N., Coroleu, B., Buxaderas, R., Martinez, F. and Balasch, J. (2001) Risk factors for high-order multiple implantation after ovarian stimulation with gonadotropins: evidence from a large series of 1878 consecutive pregnancies in a single centre. Hum. Reprod., 16, 2124–2129.
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