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Chapter 2 - Assisted Conception and Multiple Pregnancy

Strategies to Reduce Rates

Published online by Cambridge University Press:  11 October 2022

By
Mariano Mascarenhas  and
Adam Balen
Edited by
Leanne Bricker ,
Julian N. Robinson  and
Baskaran Thilaganathan
Leanne Bricker
Affiliation:
Corniche Hospital, Abu Dhabi
Julian N. Robinson
Affiliation:
Brigham & Women's Hospital, Boston
Baskaran Thilaganathan
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Assisted conception is associated with a higher risk of multiple pregnancy than natural conception. Both ovulation induction and IVF are associated with a higher risk of multiple pregnancies, but the latter contributes to most of the multiple pregnancies following assisted conception treatment. The adverse obstetric and perinatal outcomes of multiple gestations are amplified if the pregnancy was conceived after infertility treatment. The risk of multiple pregnancy after ovulation induction (with or without intrauterine insemination) appears to be linked to the number of follicles recruited whilst the risk after IVF is related to the number of embryos transferred. Aiming for uni-follicular recruitment reduces the risk of multiple pregnancy following ovulation induction and performing a single embryo transfer in IVF cycles reduces the risk of dizygotic twinning. Some of the laboratory techniques used in IVF such as culture to the blastocyst stage and pre-implantation genetic testing elevate the risk of monozygotic twinning.

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Chapter
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Management of Multiple Pregnancies
A Practical Guide
 , pp. 11 - 17
Publisher: Cambridge University Press
Print publication year: 2022

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