Successful Fertility Treatment May Mean More Babies Than Planned
WebMD News Archive
The final chapter in reducing the risk of high-order multiples has yet to be
written, David Meldrum, MD, tells WebMD. "Gonadotropins are a big cause of
high-order multiples, and their results are more difficult to control than is
in vitro fertilization in which only two embryos are transferred," he says.
His preference is for continued conservative use of this medication, along with
transfer of fewer embryos with IVF. Meldrum, scientific director of the
Reproductive Partners Medical Group in Redondo Beach, Calif., and a clinical
professor of medicine at the University of California at Los Angeles, provided
WebMD with an objective analysis of the study.
Although avoiding high-order multiple pregnancies is a goal shared among
many fertility specialists, several strategies are being explored, Edward E.
Wallach, MD, tells WebMD. "The authors' approach is not very revolutionary,
but they touch on a very important subject," says Wallach, who is director
of the assisted reproductive technology program at Johns Hopkins University
School of Medicine. "In our program, if we are inducing ovulation with
gonadotrophins and it appears that there is a risk of a high-order multiple
pregnancy, ... we take one of two approaches. We either cancel the cycle, or
offer the couple IVF at that point. Both of those actions reduce the chance of
high-order multiple pregnancies." Extending the culture of the embryos to
the blastocyst stage, and then implanting fewer embryos, also can help reduce
the risk, Wallach says.
- Couples who seek medical help to have a baby may discover a complex
situation: Depending on the treatment used, a woman often stands a better
chance of pregnancy when more than one fertilized egg reaches the uterus at one
time. But multiple pregnancies can jeopardize the safety of mother and
- A recent review of nearly 1,500 cases showed current treatment practices
produced unacceptably high numbers of multiple pregnancies.
- One doctor notes patients and their doctors need to discuss all the
complications and concerns that multiple births can create.