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The Risks of Multiple Pregnancy Associated with IVF
In-Vitro fertilitization (IVF) is an exciting therapy that offers many
infertile couples the opportunity to achieve pregnancy that would not
otherwise exist. It’s important for couples to remember that as they
consider IVF, they need to know it has played a significant role in
increasing the incidence of high order multiple pregnancies (triplets or
more) since its introduction in 1978.
The goal of infertility treatment is the delivery of a full-term,
healthy infant. Multiple pregnancy – especially high order multiple
pregnancy – clearly puts this goal at risk. Maternal complications of
high order multiple pregnancy include:
§ pre-eclampsia
§ excessive weight gain
§ anemia
§ chronic back pain
§ possible damage to the anterior abdominal wall
More importantly, fetal complications include prematurity and the
resulting increase in infant morbidity and mortality. Furthermore, the
rearing of high order multiples creates physical, emotional and
financial stress for the family with a reported increase in the
incidence of maternal depression and anxiety. For these reasons,
reducing the number of high order multiples has become an essential goal
of most successful IVF programs.
Two relatively new developments in the art and science of IVF appear to
significantly decrease the need to transfer a large number of embryos
and therefore, offer the promise of decreasing the incidence of high
order multiple pregnancies. In 1990, preimplantation genetic diagnosis
(PGD) became a reality. Embryos created through IVF can now be tested
for age-related genetic abnormalities. This screening allows the
clinician to transfer fewer PGD screened embryos in women 35 years of
age and older, while still maintaining high rates of pregnancy.
The second significant development has been the ability to keep embryos
in culture for 5 days (blastocyst stage) instead of 2 or 3 days
(cleavage stage) prior to transfer. Blastocysts are more likely to
implant and lead to pregnancy. Therefore, the fewer blastocysts
(usually only 2) need to be transferred in order to maintain good
pregnancy rates. Fertility Centers of Illinois is one of the few
practices in the nation that is able to offer patients both of these
procedures.
Angie N. Beltsos, M.D. is board certified in both obstetrics and
gynecology and reproductive endocrinology. Dr. Beltsos completed her
residency in obstetrics and gynecology at Loyola University followed by a
two-year fellowship in reproductive endocrinology and infertility at
Washington University in St. Louis, MO. Dr. Beltsos is currently a
Clinical Assistant Professor in reproductive endocrinology at Loyola
Medical School, Chicago, IL, and has participated in numerous research
projects.
Phone: 847-215-8899
Email: Angeline.Beltsos@integramed.com
Website: http://www.fci-online.com
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