A 47-Year-Old Woman With Fertility Problems Who Desires a Multiple Pregnancy

Embryo transfer practices in the United States: a survey of clinics registered with the Society for Assisted Reproductive Technology

“…Before embryo transfer policy is legislated, however, it is important to consider what factors influence embryo transfer practices. Previous studies suggest that PRs at individual clinics (15), patient funding for IVF (8), and patient preference (16)(17)(18)(19) are important, but little is actually known regarding factors US clinicians take into consideration when deciding how many embryos to transfer. To gain a better understanding of these factors, we conducted a survey of clinicians practicing in IVF centers registered with SART.…”

Paternity Balancing

“…They stated they would rather put the risks on the generation of multiples, which can be addressed, rather than potentially needing additional, expensive cycles to achieve a pregnancy. None expressed to us the primary desire for twins with paternity balancing although the desire for twins has been documented in the literature [12]. It was an afterthought beyond first achieving a pregnancy.…”

“…We and other groups have seen the practice evolve over 25 years with a better understanding of specific risks and benefits in differing situations [6,11,12,13,14,15]. The most common starting number has fallen from quadruplets to triplets, and now twins to singleton constitute about 1/3 of cases performed by us [6,11].…”

“…Over time, FISH will certainly be replaced by other molecular techniques that should be cheaper and potentially faster. Technology advancements have also allowed older women to be candidates triggering fertility, medical, and genetic issues simultaneously [12]. Likewise, the experience of IVF and its uses has set precedents for how outcome data are sought, collected and distributed [13].…”

The Suleman octuplets: What can an aberration teach us?

“…When we compare the time of Faber's comments, 1997, to the last published SART-Centers for Disease Control data in 2007 (6), goodprognosis patients demonstrated an 87% decrease in high-order multiple pregnancy (HOMP), from 14% to 1.8%, as the average number of embryos for transfer steadily dropped, all while the number of initiated cycles and percentage live births steadily increased (7). Only the twin rate remains elevated, but this too can be decreased with elective single-embryo transfer (eSET) (8).…”