Beth A. Malizia, M.D., Laura E. Dodge, M.P.H., Alan S. Penzias, M.D., Michele R. Hacker, Sc.D.
Volume 99, Issue 2, Pages 393-399, February 2013
To estimate the cumulative probability of liveborn multiples after in vitro fertilization (IVF) to improve patient counseling regarding this significant morbidity.
Retrospective cohort study.
Large academic-affiliated center.
A total of 10,169 women were followed from their first fresh, non-donor IVF cycle through up to 6 fresh and frozen IVF cycles from 2000-2010.
Main Outcome Measures:
Delivery of a liveborn infant(s).
After 3 IVF cycles the cumulative live birth rate (CLBR) was 53.2%. The singleton, twin and triplet CLBRs were 38.0%, 14.5% and 0.7%. After 6 IVF cycles the CLBR was 73.8%, with 52.8%, 19.8%, 1.3% for singletons, twins and triplets. Of the 5,433 live births, 71.4% were singletons, 27.1% were twins and 1.5% were triplets. Women over 39 had the lowest incidence of liveborn multiples with CLBRs of 5.2% after 3 cycles and 9.5% after 6 cycles. The twin CLBR doubled from cycles 1 through 3 with the rate of increase slowing from cycles 3 through 6. While very low in absolute terms, the triplet CLBR also doubled from cycles 1 through 3 and doubled again from cycles 3 through 6. Of the 1,970 pregnancies that began as multifetal on ultrasound, 77.4% resulted in liveborn multiples.
Providers should be aware of the cumulative probability of liveborn multiples in order to effectively counsel patients on this important issue. While nearly three-quarters of all women had a live birth after up to 6 IVF cycles, it is encouraging to report a low incidence of liveborn multiples.
Read the full text at: http://www.fertstert.org/article/S0015-0282(12)02318-7/fulltext