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study published Dec. 5, 2013 in the New England
Journal of Medicine detailed the growth in multiple births resulting from
assisted reproduction methods. It also revealed a surprising finding: fertility drugs are the culprit behind most
multiple births, not in vitro fertilization (IVF), as was previously thought.
clinics have become a lot better at reducing the number of embryos that are put
back in a woman’s uterus after IVF, a trend that has contained the number of
multiple pregnancies after IVF, especially triplets and higher-order
multiples,” says epidemiologist Maurizio Macaluso, MD, DrPH. “By contrast, little can be done to reduce the number
of embryos that result from combining ovarian stimulation and intrauterine
insemination, a very popular form of infertility treatment.”
who is Director of Biostatistics and Epidemiology at Cincinnati Children’s, joined with colleagues at
institutions around the country in the study. Their goal was to understand and
try to halt the upward trend in multiple births. Even with advances in pre- and
post-natal care, multiple births are risky for both moms and babies.
size of a healthy full-term baby is almost at the anatomical limits of the
mother’s womb, and to accommodate a multiple pregnancy the babies have to be
smaller and must be delivered earlier,” Macaluso says. “This results in
increased risk of adverse health outcomes for both mother and children.”
researchers compared data on multiple births from a period before and after
fertility treatments became available in this country. Among their findings: by
2011, 36 percent of twins and 77 percent of triplets, quads and quintuplets
were born as a result of fertility treatments, including fertility drugs.
researchers found that multiple births from IVF dropped after 1998 following
guidelines limiting embryo transfers in IVF issued by the Society for Assisted
Reproductive Technology. However, non-IVF treatments such as fertility drugs
continued to cause multiple births. Non-IVF twin births increased by 3 percent
and triplet births increased from 36 percent to 45 percent between 1998 and
Fertility drugs are the reason behind most multiple births, not in vitro fertilization (IVF), as was previously thought.
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