Human Reproduction, Vol. 15, No. 8, 1663-1665,
August 2000
© 2000 European Society of Human Reproduction and Embryology
Debate continued |
Avoiding multiple pregnancies in ART
Double trouble: yes a twin pregnancy is an adverse outcome
ART unit, Department of Obstetrics and Gynecology, Hôpital A.Béclère, Clamart, France
The frequency of twins has increased by 30% between 1972 and 1990 in France, USA and England (Tuppin et al., 1993
; Luke et al., 1994; Dunn et al., 1996). Twin pregnancies represented a mean of 24.7% of IVF pregnancies as reported in the last World Collaborative Report on IVF (De Mouzon and Lancaster, 1997). In some IVF centres this rate can be as high as 40–50% as seen regularly in meeting presentations.
Almost no large scale data are available to assess with precision the exact rate of twins in ovarian stimulation outside IVF. A study carried in France in 1993, showed that 63% of twin pregnancies originated from ovarian stimulation, 19.5% after IVF and 43.5% without IVF (Blondel et al., 1996).
Triplet pregnancies (or pregnancies of higher order) are clearly considered as the major adverse outcome of assisted reproductive technologies (ART). Selective embryo
Maternal morbidity and mortality
Higher maternal mortality
Higher maternal morbidity
Perinatal outcome
Greater prematurity
Lower birth weight
Higher neonatal mortality
Greater number of handicaps
More malformations
Psychological consequences
Conclusions
Acknowledgments
Notes
References
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