An Overview of Temporal Trends in Multiple Births After Assisted Reproductive Technology in the USA

Data for 2003, 2007 and 2011 were taken from National Clinic Summary Reports [201].
Data for 1995 and 1999 taken from [2].
NA: Not available.

Data for 2003, 2007 and 2011 were taken from National Clinic Summary Reports [201].

Authors and Disclosures

Judy E Stern
Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, The Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA.

Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.

*Author for correspondence
Tel.: +1 603 653 9248 Fax: +1 603 650 0905 judy.e.stern@dartmouth.edu

Sidebar

Key Issues

• Multiple birth rate has been the most significant risk of assisted reproductive technology from early in its use.

• All multiple embryo transfer must balance achieving high live birth rates with the risk of multiple birth.

• Increasing live birth rates have helped reduce the number transferred.

• Professional guidelines have helped to define expected practice and reduce the number transferred.

• In Europe, laws calling for reduction in the number transferred have had mixed effectiveness. There are high rates of single embryo transfer in some countries but other countries that require transfer of all fertilized embryos still have higher multiple birth rates.

• Per cycle reporting of results may hurt rather than help the effort to decrease the number transferred. Reporting of cumulative delivery rates, particularly through the method of total reproductive potential where rates are reported per retrieval and include frozen embryo transfers, may help redefine effectiveness and increase the acceptance of single embryo transfer.

• New methods for choosing the best embryo to transfer are on the horizon, however, none of these is yet in general use.

• We have sharply reduced the number transferred over the past 30 years. This effort has been more successful for younger women (<35 years) than older women (>40 years). Improvements will continue to be made.