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    Successful Fertility Treatment May Mean More Babies Than Planned


    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.

    Vital Information

    • 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 developing babies.
    • 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.
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