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

Judy E Stern


Expert Rev of Obstet Gynecol. 2013;8(4):357-368. 

In This Article


Practitioners of ART still confront many of same issues in 2013 as in the 1980s. There is a need to balance effectiveness – measured as live birth rates or implantation rates – with multiple birth rates and this balance still influences the number of embryos being transferred. There continues to be inadequate insurance coverage and the same pressures on patients and providers to have procedures result in effective treatment. Nevertheless, improved methods have steadily increased live birth rates and professional guidelines have progressively helped reduce the number of embryos transferred. Proposals to report live birth rates per patient or per retrieval can help us recast our understanding of effectiveness in terms of healthy singleton delivery. Though progress has been made, we have not yet gotten to SET for all. This final step, and eliminating twins, may be aided by the implementation of newer techniques for embryo section. We have made significant progress on reducing multiples and the goal of ART treatment to result in singleton delivery is now in sight.