Multiple births - their risks and how to prevent them

Vienna, Austria: The continuing high rate of multiple pregnancies in assisted reproduction is a major medical, psychosocial and economic problem. But it could be solved overnight if only doctors weren't too hesitant to act, a leading Swedish specialist in reproductive medicine told a news briefing today (Monday 1 July) at the annual meeting of the European Society of Human Reproduction and Embryology in Vienna.

Dr Karl Nygren, Associate Professor of Obstetrics and Gynaecology at Sofiahemmet Hospital in Stockholm, said that the natural rate of multiple births was around one percent but was between 20% and 40% for women who used assisted reproductive techniques either ovarian stimulation or IVF, or a combination.

"The reason for multiple pregnancies is the drive to maximise effectiveness. More embryos per transfer means higher efficacy and a shorter period of time to achieving births. However, evidence is accumulating that a policy leading to multiple births means increased risk of prematurity and, consequently higher mortality, disability and ill health. There are also psychosocial problems more difficult pregnancies, more caesarean sections, prolonged breast feeding and extra stress, particularly for the mother and especially during the early years of childhood. The economic consequences can be overwhelming as well."

Dr Nygren said that the push for multiple pregnancies was driven by a combination of factors • costs more babies in one go gets round the problem of lack of resources hindering further attempts, while the high costs of treating premature babies resulting from multiple pregnancies are usually met from different sources than those financing reproductive treatment • patients' wishes they want to meet their reproductive goals as quickly as possible • ompetition among doctors a reputation for excellence and success attracts resources efficacy is often reported without due observation of the multi

Contact: Margaret Willson
European Society for Human Reproduction and Embryology

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